title: Lesson of the month 1: A rash decision.
abstract: Cellulitis is a common condition and several mimics exist which should be considered in patients who fail to respond to antibiotics. We describe the case of a patient with anaplastic large cell lymphoma masquerading as a lower leg cellulitis. The patient had failed to respond to intravenous antibiotics and a skin biopsy confirmed her diagnosis. She received radical radiotherapy to the lower leg but later developed shortness of breath and was identified to have pulmonary infiltration of the lymphoma. She died shortly afterwards from lobar pneumonia. This case highlights the importance of regularly reassessing patients with suspected cellulitis and considering alternative diagnoses in cases that fail to respond to treatment.
authors.affiliation: Kingston Hospital NHS Foundation Trust, Kingston upon Thames, UK; catherine.sedgwick@ymail.com.
authors.forename: Catherine L
authors.initials: CL
authors.lastname: Sedgwick
authors.affiliation: Kingston Hospital NHS Foundation Trust, Kingston upon Thames, UK;
authors.forename: Peter E
authors.initials: PE
authors.lastname: Hall
authors.affiliation: Kingston Hospital NHS Foundation Trust, Kingston upon Thames, UK;
authors.forename: Abarna
authors.initials: A
authors.lastname: Ratnarajah
authors.affiliation: Kingston Hospital NHS Foundation Trust, Kingston upon Thames, UK;
authors.forename: Janakan
authors.initials: J
authors.lastname: Natkunarajah
authors.affiliation: Kingston Hospital NHS Foundation Trust, Kingston upon Thames, UK.
authors.forename: Louise
authors.initials: L
authors.lastname: Hogh
mesh_terms: D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002481:Cellulitis / Q000175:diagnosis* / Q000188:drug therapy; D003937:Diagnosis, Differential; D017809:Fatal Outcome; D006801:Humans; D007866:Leg / Q000473:pathology; D008175:Lung Neoplasms / Q000175:diagnosis; D017728:Lymphoma, Large-Cell, Anaplastic / Q000175:diagnosis*; D008297:Male; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000473:pathology
chemical_list: D000900:Anti-Bacterial Agents
keywords: Cellulitis; lymphoma; skin biopsy
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