1. Sarcoidosis presenting as facial and scalp ulceration with secondary bacterial infection of the skin.
- Author
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Fram G, Kohli S, Jiang A, and Kaatz S
- Subjects
- Administration, Intravenous, Aged, Anti-Bacterial Agents administration & dosage, Anti-Bacterial Agents therapeutic use, Coinfection drug therapy, Coinfection microbiology, Diagnosis, Differential, Face pathology, Humans, Male, Pseudomonas aeruginosa isolation & purification, Sarcoidosis pathology, Scalp pathology, Staphylococcal Infections drug therapy, Staphylococcus aureus isolation & purification, Steroids administration & dosage, Steroids therapeutic use, Syncope diagnosis, Syncope etiology, Treatment Outcome, Coinfection complications, Sarcoidosis complications, Skin Ulcer pathology
- Abstract
A 67-year-old man with a medical history of multiorgan sarcoidosis was admitted to the hospital with skin ulceration and a superimposed polymicrobial infection that had failed outpatient management. The patient's outpatient regimen included doxycycline, ciprofloxacin and moderate-dose prednisone therapy for a coinfection with Pseudomonas aeruginosa and methicillin-susceptible Staphylococcus aureus The patient presented after a syncopal episode initially thought to be due to severe dehydration. Owing to concern for cardiac sarcoidosis as well as worsening skin lesions, he was admitted to the hospital for cardiac monitoring and intravenous antibiotics. On admission, we broadened antibiotic coverage and initiated high-dose steroids at 1 mg/kg/day of prednisone. He was discharged on intravenous antibiotics and a slow steroid taper 3 days later. At the patient's 1-month and 5-month follow-up clinic visits, he demonstrated remarkable improvement of his scalp and facial wounds., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2019. No commercial re-use. See rights and permissions. Published by BMJ.)
- Published
- 2019
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