title: Fulminant ecchymosis as the initial manifestation of antiphospholipid syndrome (APS) triggered by respiratory syncytial virus (RSV) infection: A case report and review of the literature.
abstract: We present a unique and informative instance of respiratory syncytial virus (RSV) infection associated with antiphospholipid syndrome (APS), and discuss this case in the context of the literature addressing the immunopathogenesis of APS associated with diverse infections. We describe the case of a 43-year-old man with no significant past medical history who presented with the acute onset of fever, hemoptysis, and extensive bullous, ecchymotic lesions in both lower extremities. Punch biopsy of the lesion demonstrated thrombotic vasculopathy. Further evaluation revealed serum antiphospholipid antibodies as well as a positive RSV PCR in a nasal swab specimen. Clinical manifestations, positive laboratory and pathological findings were strongly suggestive of APS associated with a recent RSV infection. When an infectious etiology is considered for APS, RSV should also be included in the differential diagnosis.
authors.affiliation: Division of Infectious Diseases, Department of Medicine, Mount Sinai Beth Israel Medical Center, 19 Baird Hall, 16th Street at First Avenue, New York, NY 10003, USA.
authors.forename: Jun
authors.initials: J
authors.lastname: Makino
authors.affiliation: Division of Infectious Diseases, Department of Medicine, Mount Sinai Beth Israel Medical Center, 19 Baird Hall, 16th Street at First Avenue, New York, NY 10003, USA.
authors.forename: Sanjana
authors.initials: S
authors.lastname: Koshy
authors.affiliation: Division of Infectious Diseases, Department of Medicine, Mount Sinai Beth Israel Medical Center, 19 Baird Hall, 16th Street at First Avenue, New York, NY 10003, USA.
authors.forename: Sonal
authors.initials: S
authors.lastname: Bajaj
authors.affiliation: Division of Infectious Diseases, Department of Medicine, Mount Sinai Beth Israel Medical Center, 19 Baird Hall, 16th Street at First Avenue, New York, NY 10003, USA.
authors.forename: Young-Gwang
authors.initials: YG
authors.lastname: Jeong
authors.affiliation: Division of Infectious Diseases, Department of Medicine, Mount Sinai Beth Israel Medical Center, 19 Baird Hall, 16th Street at First Avenue, New York, NY 10003, USA.
authors.forename: David C
authors.initials: DC
authors.lastname: Perlman
keywords: Anticardiolipin antibodies (aCL); Antiphospholipid syndrome (APS); Respiratory syncytial virus (RSV)