The 469th case: multiple cutaneous abscesses, pelvic mass, and lung cavities
10.3760/cma.j.issn.0578-1426.2019.04.021
- VernacularTitle:临床病例讨论第469例——皮肤多发脓肿、盆腔包块、肺内空洞
- Author:
Xiaoyu CAO
1
;
Jiuliang ZHAO
;
Yangzhong ZHOU
;
Baotong ZHOU
;
Qingjun WU
;
Xiaofeng ZENG
Author Information
1. 中国医学科学院北京协和医学院北京协和医院风湿免疫科 100730
- Keywords:
Multiple abscess;
Fever;
Granulomatosis with polyangiitis
- From:
Chinese Journal of Internal Medicine
2019;58(4):333-336
- CountryChina
- Language:Chinese
-
Abstract:
A 28-year-old woman with multiple abscesses for 2 month and fever for 1 month was admitted in Peking Union Medical College Hospital.The skin abscesses gradually developed at skull,face,abdominal wall and pelvis.Laboratory examinations related to inflammatory reactions were strongly high including erythrocyte sedimentation rate 99 mm/1 h,C-reactive protein160.28 mg/L and ferritin 1 584 μg/L.Multiple nodules and cavities were detected in lungs.And vesico-cervical fistula was found during exploratory laparotomy.The pathological tests of abdominal tissues demonstrated necrosis and granuloma.Evidence of infectious diseases was not definite.Positive anti-proteinase 3 (PR3) antibody confirmed the diagnosis of granulomatosis with polyangiitis.After treated with glucocorticoid and immunosuppressants,the patient's symptoms improved remarkably.This case suggested that systemic vasculitis should be considered as a differential diagnosis of multiple abscesses which are not explained by infections.
