Acute Myelogenous Myelomonocytic Leukemia

A middle-aged woman had had a low-grade fever, sore throat, and malaise for 1 week. Her physician prescribed amoxicillin(. Three days after starting the medication, an asymptomatic erythematous and petechial eruption developed over the patient’s entire body. A skin biopsy ruled out a drug reaction and confirmed the diagnosis furnished by a blood test: the patient had acute myelogenous myelomonocytic leukemia. The patient’s rash was caused by leukemic infiltrates; the prodromal symptoms were manifestations of leukemia, not a bacterial or viral syndrome. The antibiotic was discontinued; chemotherapy was initiated. (Case and photograph courtesy of Dr David L. Kaplan.)