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ACCP-SEEK Board Review Question of the Month |

72-Year-Old Man With Fever, Skin Lesions, and Consolidation on Chest Radiograph*

W. Michael Alberts
Author and Funding Information

*From the Thoracic Oncology Program, H. Lee Moffitt Cancer Center, University of South Florida, Tampa, FL.

Correspondence to: W. Michael Alberts MD, MBA, FCCP, Associate Center Director for Clinical Affairs/Chief Medical Officer, H. Lee Moffitt Cancer Center, University of South Florida, 12902 Magnolia Dr, Tampa, FL 33612-9416; e-mail: alberts@moffitt.usf.edu



Chest. 2000;118(3):861-862. doi:10.1378/chest.118.3.861
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A 72-year old man was admitted to the hospital with a fever as high as 39°C; mild dyspnea; and tender, erythematous, vesicular skin lesions on his lower legs, forearms, and neck (Fig 1 ). A chest radiograph showed patchy consolidation in the right upper, right lower, and left lower lobes. Medical history was remarkable for a 1-year history of myelodysplastic syndrome. On admission, his hemoglobin level was 8.5 g/dL, and WBC count was 6 × 109/L, with a differential of 52% segmented neutrophils, 20% lymphocytes, 26% monocytes, and 2% eosinophils. The platelet count was 80 × 109/L. Appropriate blood, sputum, urine, and skin cultures were obtained, and the patient was empirically started on IV ampicillin.

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