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A man with fever and rash
  1. Yuki Nakanishi1,
  2. Hirokazu Toyoshima1,
  3. Hiromu Takeda2
  1. 1 Infectious Diseases, Japanese Red Cross Ise Hospital, Ise, Japan
  2. 2 General Medicine, Nabari City Hospital, Nabari, Japan
  1. Correspondence to Dr Yuki Nakanishi, Infectious Diseases, Japanese Red Cross Ise Hospital, Ise 516-8512, Japan; y.naka.127.327{at}

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Clinical introduction

A 56-year-old Japanese man with a medical history of diffuse large B-cell lymphoma presented to the emergency department (ED) with fever lasting for 15 hours. He also had vomiting and hematochezia. He had no history of travel or outdoor activities. His blood pressure was 119/90 mm Hg, heart rate 98 beats/min, respiratory rate 24 breaths/min, temperature 34.6℃; SpO2 could not be measured. Skin findings are shown (figure 1). Heart, lung and abdominal findings were unremarkable. Laboratory tests revealed leucopenia (1.01×109/L), thrombocytopenia (16×109/L), INR 1.49, APTT 74.4 s, FDP 183 µg/mL and lactic acidosis (pH …

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  • Contributors YN: Involved in designing the project and writing the manuscript. H Toyoshima and H Takeda: Involved in manuscript writing and editing. All authors have read and approved the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting or dissemination plans of this research.

  • Provenance and peer review Not commissioned; internally peer reviewed.