Skin Lesions and Neutropenic Fever in a 69-Year-Old Woman

Cameron Nichols, MD; Fnu Nutan, MD


June 26, 2020

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A 69-year-old woman presents with neutropenic fever and painful skin lesions. She has a past medical history of myelodysplastic syndrome, neutropenia, chronic obstructive pulmonary disease, and cirrhosis. The skin lesions began 2 weeks prior as small nodules that progressed to painful, red plaques. At that time, they were present on her back, left breast, and right posterior calf.

She also experienced fevers up to 102°F (38.9°C) over the last week. She describes having shortness of breath with myalgias over the last few weeks, in addition to a more recent onset of cough, nausea, and diarrhea. She has no lesions in her mouth or her genitals and reports no vision changes.

Her myelodysplastic syndrome has been treated with azacitidine, which she last received 3 weeks prior. She has a right internal jugular port-a-cath, in which a needle was recently dislodged. She has not had any pain since that time.


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