Acute monocytic leukaemia presenting as a febrile rash
Keywords:
rickettsiosis, leukaemia cutis, acute monocytic leukaemiaAbstract
Cutaneous involvement has been described in all forms of acute
myeloid leukaemia as well as in other forms of myeloproliferative disease.
We describe a clinical case of a 70 year-old female, whose
first manifestation of leukaemia was a 5 day history of diffuse
cutaneous rash, fever and muscle pain. Epidemiologically, she was
a street vendor and had contact with dogs and cats.
On clinical examination she was febrile and presented papules
and nodules over her entire body, hands and feet included. Her
laboratory data showed thrombocytopaenia and elevation of
aminotransferases and lactic dehydrogenase. The patient was
admitted into an Internal Medicine ward with the diagnosis of
Mediterranean spotted fever. Rickettsia conorii serological titre
was positive although with a low level.
The presence of myelocytes and metamyelocytes in peripheral
blood motivated the realization of a bone marrow aspirates study
which revealed an acute myeloblastic leukaemia. The skin biopsy
demonstrated infiltration by acute monocytic leukaemia. We
discuss some particularities of the case.
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