We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Cutaneous polyarteritis nodosa: a report of a case associated with melioidosis (Burkholderia pseudomallei).
- Authors
Choonhakarn, Charoen; Jirarattanapochai, Kunya
- Abstract
A 22-year-old Thai woman was hospitalized with a 1-month history of high-grade fever and slowly progressing multiple erythematous painful nodules on both legs. A history of arthralgia in the knee and ankle joints was presented. She had been treated with acetaminophen and a non-steroidal anti-inflammatory drug (NSAID) from a provincial hospital before, but without improvement. She denied the histories of upper respiratory tract infection, jaundice, tuberculosis, and taking any drugs before skin eruption. On physical examination, she had a temperature of 40 °C, a pulse rate of 90 beats per minute, a respiratory rate of 22 breaths per minute, and a blood pressure of 110/60 mmHg. She had multiple 1–4 cm erythematous, oval, tender, nodules on the pretibial area of both legs. Some nodules also had fluctuation and hemorrhagic bullae (Fig. 1). Other physical examinations were normal, except for positive splenic dullness on percussion. Test results from the following laboratory studies were normal; hematocrit, platelet, urinalysis, serum urea nitrogen, creatinine, electrolyte, amylase, liver function test, venereal disease research laboratory (VDRL) test, anti-streptolysin O, anti-nuclear antibody, and hepatitis B surface antigen and antibody. Tuberculin test was negative. The chest X-ray film was normal. Hemoculture and fluid culture from bullae showed no growth of organisms. The leukocyte count was 15.1×109 /L, with a differential cell count of neutrophils 73%, lymphocytes 19%, monocytes 7%, and eosinophils 1%. Melioid titer (by indirect hemagglutination test) was 1: 2560. Ultrasound of the abdomen revealed splenomegaly with multiple, variously sized hypoechoic lesions in the spleen. The liver, gall bladder, pancreas, and kidneys appeared normal. A skin biopsy specimen from the inflammatory nodule on the leg showed perivascular and transmural neutrophilic and lymphocytic infiltration of medium-sized arteries in the dermal-subcutaneous...
- Subjects
THAILAND; POLYARTERITIS nodosa; MELIOIDOSIS
- Publication
International Journal of Dermatology, 1998, Vol 37, Issue 6, p433
- ISSN
0011-9059
- Publication type
Article
- DOI
10.1046/j.1365-4362.1998.00403.x