case_images: PMC11809608_01
case_images: Tense bulla with clear fluid on the right upper extremity of the patient. Note the erythematous rash with erosions and blistering.
case_images: jmc-16-069-g001.jpg
case_images: PMC11809608_01_jmc-16-069-g001.jpg
case_images: F1
case_images: A few days after the 21st cycle, the patient developed an erythematous and pruritic rash with erosions and blistering in his chest, abdomen, back, and extremities, covering approximately 10% of his body surface area (BSA) (Fig. 1).
case_images: The chest X-ray showed a nonspecific pattern of bilateral interstitial infiltrates.
case_images: jmc-16-069-g002.jpg
case_images: PMC11809608_01_jmc-16-069-g002.jpg
case_images: F2
case_images: Chest X-ray (CXR) revealed bilateral interstitial infiltrates, and chest computed tomography (CT) pulmonary angiogram (CTPA) suggested PE (Fig. 2).
case_images: Chest CTPA reveals the presence of honeycombing, traction bronchiectasis, and ground glass opacities suggestive of nonspecific interstitial pneumonitis. CTPA: computed tomography pulmonary angiogram.
case_images: jmc-16-069-g003.jpg
case_images: PMC11809608_01_jmc-16-069-g003.jpg
case_images: F3
case_images: CTPA also revealed enlarged mediastinal lymph nodes, bilateral and symmetric honeycombing, traction bronchiectasis, and ground glass opacities (Fig. 3). Consequently, the patient was admitted to the hospital and was treated with subcutaneous (SC) fondaparinux 7.5 mg once a day and intravenous (IV) antibiotic regimens including piperacillin/tazobactam-moxifloxacin and then linezolid-meropenem without improvement.