Abstract
N/A- Case report
Highlights
Accurate diagnosis, and prompt treatment, of a severe necrotising soft-tissue infection is one of the few diagnoses in plastic surgery that, if managed correctly, can be life-saving
Serial examinations will show failure to respond to antibiotics and progressive systemic signs of sepsis including haemodynamic instability, acidosis, leucocytosis and hyperthermia
Described below is the diagnostic conundrum of a patient presenting with a rare type of cutaneous lymphoma, primary cutaneous gamma-delta T-cell lymphoma (PCGDTL) associated with haemophagocytic lymphohistiocytosis (HLH), mimicking a necrotising soft-tissue infection
Summary
Prompt treatment, of a severe necrotising soft-tissue infection is one of the few diagnoses in plastic surgery that, if managed correctly, can be life-saving. Described below is the diagnostic conundrum of a patient presenting with a rare type of cutaneous lymphoma, primary cutaneous gamma-delta T-cell lymphoma (PCGDTL) associated with haemophagocytic lymphohistiocytosis (HLH), mimicking a necrotising soft-tissue infection. The patient continued to deteriorate with multiorgan failure and disseminated intravascular coagulation requiring mass blood transfusion He gradually stabilised and was transferred to the ward under the multidisciplinary care of plastic surgery, general medicine and infectious diseases. Several weeks into his admission, with ongoing high-grade fevers and negative cultures, the patient developed multiple areas of non-tender plaque-like rash over his torso and limbs (Figure 1). The patient’s symptoms and fever settled once chemotherapy commenced
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