A 51-year-old hypertensive woman with a history of chronic renal failure, who was receiving haemodialysis through a permanent catheter in the right internal jugular vein, presented with progressive facial oedema and sudden hoarseness. Cavography with iodine contrast was performed, which showed 95% obstruction of blood flow through the superior vena cava, and the patient was diagnosed with superior vena cava syndrome. Several hours later, painful pustules developed on the patient's face. Cavography was repeated to remove the catheter from the jugular vein, and a new catheter was placed in the right femoral vein. One day later, the patient developed pruritic, tense haemorrhagic bullae on her arms and legs. The facial pustules coalesced into vesicles and vegetating lesions appeared, with drainage of purulent secretion on the patient's face (Fig. 1). The patient was afebrile with stable vital signs. Laboratory studies indicated eosinophilia (35% eosinophils; normal range 1-4%), while white cell count was normal (9.85 9 10 9 /L; normal range 4-11 9 10 9 /L). Histopathological findingsThe results of microbiological studies were negative. Histopathological examination of an arm lesion revealed epidermal necrosis with ulceration and a mixed infiltrate with predominance of neutrophils in the dermis, dermal and epidermal necrosis with haemorrhagic areas and a superficial neutrophilic infiltrate (Fig. 2). Figure 1 (a) Tense haemorrhagic bullae on the patient's arms; (b) vegetating lesions draining purulent secretion on the patient's face.ª
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.