A58-Year-Old woman ith a skin ulcer, fever, and Lymphadenopathy Case 4-2016 from NEJM 李菁2014级硕士导师:张继明教授
Case 4-2016 from NEJM A 58-Year-Old Woman with a Skin Ulcer, Fever, and Lymphadenopathy 李菁 2014级硕士 导师：张继明教授
General information Sex: female Age: 58-year-old Symptom: an ulcerated lesion on the forehead, fever, and cervical lymphadenopathy
Sex: female Age : 58-year-old Symptom：an ulcerated lesion on the forehead, fever, and cervical lymphadenopathy 1 General information
2Present history 8 days before admission ( other hospital ): a pimplelike lesion on the left side of her forehead 5 days before admission other hospital ) a temperature of 394C, chills, myalgias, and malaise the lesion increased in size 2 days before admission other hospital ): a temperatures of 400C, chills, and myalgias tender swelling of the left side of her neck the lesion continued to enlarge, took on the appearance of a blister containing dark fluid, and then ulcerated
2 Present history : 8 days before admission（other hospital）: a pimplelike lesion on the left side of her forehead 5 days before admission（other hospital）: a temperature of 39.4°C, chills, myalgias, and malaise. the lesion increased in size 2 days before admission（other hospital）： a temperatures of 40.0°C, chills, and myalgias tender swelling of the left side of her neck the lesion continued to enlarge, took on the appearance of a blister containing dark Pluid, and then ulcerated
2 Present history Chest radiograph: normal Contrast-enhanced CT: substantial asymmetric lymphadenopathy involving the head, face, and neck on the left side Contrast-enhanced ct scans of the head and neck Intravenous clindamycin was administered and discharged home with a prescription for oral clindamycin
2 Present history Chest radiograph: normal Contrast-enhanced CT: substantial asymmetric lymphadenopathy involving the head, face, and neck on the left side Contrast-enhanced CT scans of the head and neck. Intravenous clindamycin was administered and discharged home with a prescrip6on for oral clindamycin
2 Present history 1 day before admission ( other hospital) the lesion enlarged and was painful On examination( other hospital): a temperature of 39.4 C and persistent myalgias and malaise, fatigue and weakness Additional antibiotics were administered intravenously and the patient was transferred to this hospital by ambulance
2 Present history : 1 day before admission（other hospital）： the lesion enlarged and was painful On examination（other hospital）： a temperature of 39.4°C and persistent myalgias and malaise, fatigue and weakness Addi6onal an6bio6cs were administered intravenously, and the pa6ent was transferred to this hospital by ambulance