History: A 43 y/o white male was admitted to the hospital
with a 2 year history of petechial lesions (Figure 1, 2) on the
bilateral lower extremities and a 2 week history of swelling and
pain of the right ankle (Figure 3). He denied any history of trauma,
bites, tick exposure, or new medications. Additional findings
were significant for submucosal hemorrhage of the oral mucosa
(Figure 4) and gingival hypertrophy with bleeding gums (Figure
His past medical history was noncontributory.
Social history was significant for heavy alcohol consumption
of approximately 12 beers/day.
He was not taking any medications at time of admission and denied using recreational drugs.
Laboratory data was significant for anemia (hemoglobin of 11.6, hematocrit of 34.1) and leucopenia (WBC 2.1). CMP panel was within normal limits.
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