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A correction has been published: N Engl J Med 2002;346(4):300.

Case Records of the Massachusetts General Hospital
Weekly Clinicopathological Exercises
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Volume 345:1263-1269 October 25, 2001 Number 17
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Case 33-2001— A 33-Year-Old Man with a Rash, Pulmonary Infection, and Neurologic Disorder
C. Fordham von Reyn, M.D., and Eugene J. Mark, M.D.

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Presentation of Case

A 33-year-old man was admitted to the hospital because of leg numbness and back pain.

The patient had been well until six weeks before admission, when pruritus developed on his upper abdomen, accompanied by burning pain when he assumed a recumbent position. An erythematous rash without vesicles or scarring spread across both sides of his upper abdomen to the midaxillary lines and was interpreted by a physician as herpes zoster. Within two weeks, the rash cleared spontaneously. Four days before admission, numbness developed in both legs and ascended to the lumbar region and then to the abdomen and interscapular region. . . . [Full Text of this Article]

Differential Diagnosis

Pulmonary Disease

Spinal Cord Disease

            Possible Role of HIV Infection

            Possible Role of a Monoclonal B-Cell Disorder

Rash

Clinical Diagnoses

Dr. C. Fordham von Reyn's Diagnoses

Pathological Discussion

Anatomical Diagnoses

References




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