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Case Records of the Massachusetts General Hospital
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Volume 361:900-911 August 27, 2009 Number 9
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Case 27-2009 — A 56-Year-Old Woman with Fever, Rash, and Lymphadenopathy
Jeremy S. Abramson, M.D., Subba Digumarthy, M.D., and Judith A. Ferry, M.D.

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Presentation of Case

Dr. David T. Ting (Medical Oncology): A 56-year-old woman was admitted to this hospital because of fever, rash, and lymphadenopathy.

She had been well until 11 weeks earlier when, while residing in Florida, a pustule on the right hand developed shortly after a fire-ant sting. Four hours later, rigors and fever, with temperatures as high as 38.9°C, developed. The next day, an erythematous, pruritic rash appeared on the upper left arm, and she went to the emergency department of another hospital. Analysis of the urine reportedly suggested an infection, and levofloxacin was administered. During the next 3 days, the rash . . . [Full Text of this Article]

Differential Diagnosis

Hypersensitivity Reactions

Infections

Autoimmune Conditions

Multicentric Castleman's Disease

Kikuchi's Lymphadenitis

Lymphomas

Peripheral T-Cell Lymphomas

Angioimmunoblastic T-Cell Lymphoma

Dr. Jeremy S. Abramson's Diagnosis

Pathological Discussion

Management

Anatomical Diagnosis


Source Information

From the Cancer Center (J.S.A.) and the Departments of Radiology (S.D.) and Pathology (J.A.F.), Massachusetts General Hospital; and the Departments of Medicine (J.S.A.), Radiology (S.D.), and Pathology (J.A.F.), Harvard Medical School.



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