Published: 28 January 2021
Author(s): Fabrizio Elia, Giorgia Protti, Franco Aprà
Issue: April 2021
Section: Internal Medicine Flashcard

A healthy 43-year-old man presented to the Emergency Department with a one-week history of fever, low back pain and arthralgias mainly localized in the right knee. Physical examination revealed painful swelling of the left hand and lower limb (Fig. 1A), non-tender haemorrhagic macular lesions on the soles (Fig. 1B) and signs of right knee arthritis (Fig. 1C). Laboratory tests showed aspecific neutrophilic leukocytosis. A computed tomography of the lumbar region demonstrated a paravertebral mass located at L4-L5 level, which was consistent with spondylodiscitis associated with soft tissue involvement.

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