| Popis: |
A man in his 60s presented with a painless rapidly enlarging ulcer on his left leg 1 week after the onset of diverticulitis, a neutropenic fever, and severe sepsis due to multidrugresistant Pseudomonas aeruginosa infection that necessitated admission to the intensive care unit. His medical history included a heart transplant for ischemic cardiomyopathy in his early 50s, and he was receiving long-term immunosuppressive therapy with cyclosporine, mycophenolate mofetil, and deflazacort. He had received a diagnosis of plasmablastic lymphoma 6months earlier andwas being treatedwith polychemotherapy (cyclophosphamide, doxorubicin hydrochloride, vincristine sulfate, and prednisone [CHOP] regimen). Physical examination revealed a well-demarcated 5 × 5-cm round ulcer with raised border, surrounding erythema, and a base with purulent debris (Figure 1A). A superficial swab culture sample grew P aeruginosa. A punch biopsy specimen from the edge of the ulcer was obtained and sent for histopathologic evaluation (Figure 1B). A B |
