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A 51-Year-Old Woman with Fever, Rash, and an Eschar 

A 51-Year-Old Woman with Fever, Rash, and an Eschar
A 51-Year-Old Woman with Fever, Rash, and an Eschar

Daniel Caplivski

and W. Michael Scheld

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date: 18 October 2021

Case 13c: A 51-year-old woman presented with 5 days of rash and fever. A day before her symptoms started, she noticed a small papule on her left calf that quickly became a blister, and then spontaneously opened and became black and adherent. By the next day, she developed papulovesicular rash on her face that spread over the next 2 days to her trunk and extremities. Her rash was not pruritic, but the lesion on her leg was mildly painful. She also developed fatigue, fevers (103°F), and chills that worsened over the course of the next few days. Her past medical history included poorly controlled type 2 diabetes mellitus and hypertension, for which she was taking insulin, metformin, atenolol, fosinopril, and aspirin. She immigrated to the United States from Colombia 20 years before presentation, and had always lived in the neighborhood of Jackson Heights, borough of Queens, in New York City.

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