An unusual calf lesion in an immunocompromised patient
- 18 Downloads
Dear colleagues, we present today a rare infection developed in an immunocompromised patient, which represented a diagnostic challenge while admitted to our internal medicine ward. Dr. Gili, will you please describe the patient?
A 71-year-old man affected by chronic lymphatic leukemia arrived in the emergency department with a swollen and tender right calf. The patient reported a 7-kg weight loss over the previous month and his current therapy included antiviral (acyclovir 400 mg bid) and trimethoprim–sulfamethoxazole (160 mg twice weekly) prophylaxis, prednisone 25 mg od, and a proton pump inhibitor.
Clinical examination showed normal vital parameters except for mild fever and confirmed swelling, approximately 8 cm in length, of the postero-medial region of right calf. Laboratory findings revealed mild anemia, elevated C-reactive protein levels and procalcitonin within the normal range. A previously known lesion of the left lung appeared enlarged...
Compliance with ethical standards
Conflict of interest
The Authors declare that they have no conflict of interest.
Statement of human and animal rights
All procedures performed in this study were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from the patient before applying the diagnostic and therapeutic procedures described.
- 1.Pieralli F, Corbo L, Torrigiani A, Mannini D, Antonielli E, Mancini A, Corradi F, Arena F, Moggi Pignone A, Morettini A, Nozzoli C, Rossolini GM (2017) Usefulness of procalcitonin in differentiating Candida and bacterial blood stream infections in critically ill septic patients outside the intensive care unit. Int Emerg Med 12:629–635CrossRefGoogle Scholar
- 11.Brown-Elliott BA, Biehle J, Conville PS, Cohen S, Saubolle M, Sussland D, Wengenack N, Kriel K, Bridge L, McNulty S, Vasireddy R, Wallace RJ Jr (2012) Sulfonamide resistance in isolates of Nocardia spp. from a US multicenter survey. J Clin Microbiol 50:670–672CrossRefPubMedPubMedCentralGoogle Scholar