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Skin eruption and long-lasting fever in a young man
  1. Marie Minet1,2,
  2. Nicolas Hanset3,
  3. Jean Cyr Yombi4,
  4. Halil Yildiz3
  1. 1Emergency medicine, Universite Catholique de Louvain, Bruxelles, Belgium
  2. 2Department of Pneumologie, Groupement Hospitalierde l'Ouest Lemanique S A, Nyon, Switzerland
  3. 4Department of Internal Medicine and Perioperative Medicine, Catholic University of Leuven, Brussels, Belgium
  4. 3Department of Medecine Interne, Cliniques Universitaires Saint-Luc, Bruxelles, Belgium
  1. Correspondence to Dr Halil Yildiz, halil.yildiz{at}uclouvain.be, h_tur.bel{at}hotmail.com

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A 20-year-old man presented to emergency room with a 3-week history of general weakness, fever, diffuse arthralgia and skin eruption. His medical history was unremarkable; he did not travel recently, had no contact with an ill person, nor had risky sexual behaviour and took no medication. Physical examination only showed a diffuse, non-painful, infracentimetric and non-confluent macular eruption over the trunks and limbs (figures 1 and 2). Blood test showed elevated C reactive protein and neutrophilic leucocytosis. Serologies for hepatitis C and B viruses, rubella, Epstein-Barr virus, cytomegalovirus, toxoplasmosis and HIV were negative. Urinalysis and chest X-ray were normal. Blood cultures became positive for Neisseria meningitidis, whereas skin biopsy only showed a dermic inflammatory polymorphic (lymphocytic and neutrophilic) infiltrate without specificity with negative aerobic and …

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