Interactive Case Study - April 2016

Eschar on the leg of a 56-year-old woman

Nicole M. Candelario, MD; John R. Griffin, MD

A 56-year-old woman presented to clinic for evaluation of an eschar surrounded by tender papules on the right lower extremity. She also had fever and inguinal lymphadenopathy. On further questioning, she reported recent travel to South Africa and East Africa. The histopathology is shown below in Figures 1-3.

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Figure 1. 2x

Figure 2. 10x

Figure 3. 40x

What is the best diagnosis?

Dengue

B.	Mucormycosis

C.	African Trypanosomiasis

D.	Cutaneous anthrax

E.	African tick bite fever