Case of a Cat Owner with Fever and Red Bumps

Case presentation A 48-year-old man presented with fever, red non-pruritic bumps on his arms, legs, and face, and malaise from which he had been suffering for the last two months. He had two cats at home as pets who often scratched the patient. He had a kidney transplant two years ago.

He had a history of IgA neuropathy and hypertension and was on prednisolone and cyclosporin. He had no allergies and did not drink or smoke. Physical examination Temperature: 100.2°F HEENT: Bumps 0.5 cm diameter on the nose, chin, and ear No sign of lymphadenopathy Raised bumps 0.5 cm in diameter on legs and arms but not on the trunk   Lab results WBC: 4.5 x 10 3 /mm 3 HIV: Negative Urine analysis: Normal Creatinine: Normal Transaminases: Normal Sputum: WBC- 50-100 Microorganisms: Mixed organisms Oral flora: Normal   Imaging Chest X-ray: Normal A skin biopsy showed necrotizing granulomas with negative…