Case presentation A 53-year-old male presented to the ED with a 1-month history of dyspnea, episodes of relapsing fever, and skin lesions, which were progressive in nature. Physical examination On examining the patient physically, it was observed that the patient had painful, indurated nodules on his back ( Figure 1 ), trunk, and limbs, surrounded by purple discoloration. Laboratory results White-cell count-3000 per cubic millimeter Platelet count-36,000 per cubic millimeter Ferritin level: >40,000 ng per milliliter Other diagnostic tests Bone marrow aspirated samples were collected and tested, which revealed hemophagocytosis.
The biopsy specimen was also collected from the skin lesions. A positron-emission tomography (PET) scan revealed increased fluorodeoxyglucose avidity in his skin, nasopharynx, mediastinum, abdomen, pelvis, and testes. The patient’s Epstein–Barr viral load was…
