Acute monocytic leukaemia presenting as a febrile rash

• Autor(a) principal: Marques, Nuno
• Data de Publicação: 2008
• Outros Autores: Deus, Adelaide, Ballesta, Laura, Cortesão, Emília, Almeida, Sérgio, Espadana, Ana Isabel, Aragão, António, Santos, Lèlita, Moreira, Santos, Saldanha, Maria Helena
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: https://revista.spmi.pt/index.php/rpmi/article/view/1444
• topic: rickettsiose; leucemia cutânea; leucemia monocítica aguda; rickettsiosis; leukaemia cutis; acute monocytic leukaemia

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.