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Image challenge
Bright red ear
  1. Takahiro Fukushima1,
  2. Ayano Hamai2,
  3. Yukinori Harada3
  1. 1 Department of General Internal Medicine, Kameda Medical Center, Kamogawa, Japan
  2. 2 Department of General Medicine, Awa Regional Medical Center, Tateyama, Chiba, Japan
  3. 3 Department of General Medicine, Dokkyo Medical University Hospital, Shimotsuga-gun, Tochigi, Japan
  1. Correspondence to Dr Takahiro Fukushima, Department of General Internal Medicine, Kameda Medical Center, Higashicho, Kamogawa, Japan; takafshima{at}yahoo.co.jp

https://doi.org/10.1136/emermed-2023-213244

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    Clinical introduction

    A 96-year-old woman presented to the ED with a 3-day history of fever and facial redness. She had dementia and was constantly scratching her face with itching. On examination, her body temperature was 38.2℃. The erythema was tender and confined to her face and ears. Laboratory tests showed an absolute neutrophil count of 10,900/μL and a C reactive protein level of 115 mg/L. A photograph of the patient’s face and ears at the time of presentation is shown in figure 1.

    Figure 1

    The patient’s face and ear on …

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    Footnotes

    • Twitter @AyanoHamaiMD

    • Contributors AH and YH made substantial contributions to the conception of the work. TF made significant contributions to the acquisition of data. TF drafted the original manuscript. AH and YH substantially contributed to the revision of the manuscript drafts. All authors have approved the submitted version of the manuscript and agreed to be accountable for all aspects of the work.

    • 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.

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