Case Report

A 57-year-old man with history of hypertension, hyperlipidemia,and gout presented for evaluation of both a perioral infection and an infection in his right great toe from an injury on the beach at his shore house. The toe trauma was complicated by a massive hematoma and phlebitis, which required antibiotics. His primary care physician ordered basic laboratory studies thatshowed an anemia and thrombocytopenia. He was sent to a Hematology and Oncology specialist and subsequently directly admitted to Thomas Jefferson University Hospital for blood transfusion and further work-up. Upon further questioning, thepatient admitted to chills starting 2 weeks prior to admission, elevated temperatures, rigors, dizziness, weakness, shortness of breath and a weight loss of about 16 pounds over 1 month. He denied prolonged bleeding or easy bruising, but did admit to recurrent upper respiratory infections.