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A 62-year-old man presented with a 10-day history of painful ulcerated lesions on his tongue and penis. His medical history was remarkable for a low-risk myelodysplastic syndrome, which had been treated with antithymocyte globulin and cyclosporine 1 month earlier. Clinical examination showed a large, deep, and exquisitely tender ulceration on the glans penis, with a purulent exudate (Figure 1). Also, 3 linear superficial erosions were detected on the dorsum of the tongue (Figure 2). Exudate cultures yielded Escherichia coli and Enterococcus faecalis. Antibiotic therapy with ciprofloxacin and metronidazole was unable to improve the clinical lesions, which enlarged after a few days. Laboratory evaluation was significant for a severe lymphocytopenia (lymphocytes, 300/μL [to convert to ×109/L, multiply by 0.001]). No other cutaneous or extracutaneous signs or symptoms of visceral involvement were detected. Serologic tests were negative for human immunodeficiency virus (HIV). Skin biopsy findings are shown in Figure 3.
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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature
Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal
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The Rational Clinical Examination Make the Diagnosis: Diabetes, Foot Ulcer
The Rational Clinical Examination Original Article: Does This Patient With Diabetes Have Osteomyelitis of the Lower Extremity?
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