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Papers of the Week

2021 Jul

Open Forum Infect Dis



Infection Manifesting as Leucocytoclastic Vasculitis Rash.


Hopkins BJ, Prokesch BC
Open Forum Infect Dis. 2021 Jul; 8(7):ofab333.
PMID: 34307730.


We present the first case described in the literature of leucocytoclastic vasculitis due to infection. A 73-year-old woman presented to the hospital with persistent fevers, retro-orbital headache, generalized weakness, and left lower thigh pain for 1 week. She was found to have truncal and proximal lower extremity papules and small plaques. Serology revealed immunoglobulin M (IgM) titer of 1:256 with undetectable immunoglobulin G (IgG) and undetectable IgG and IgM. Skin biopsy of an abdominal lesion revealed fibrinoid necrosis of vessel walls in the superficial and mid-dermis consistent with leucocytoclastic vasculitis. Doxycycline 100 mg orally twice daily was initiated, after which she had defervescence within 36 hours and rapid improvement of other presenting symptoms.