Physical Findings

Stop & Think

Lab and X-Ray

Differential Diagnosis

The Disease

Treatment

Conclusions

Quiz & Evaluation

• Fungi, as in the case of Mucor mycosis in immune suppressed folks. But this is typically generalized.
• Numerous viruses; consider CMV. Again this is typically a generalized condition and almost always happens in immune suppressed individuals.
• Bacteria. Again the list is long, consider Neissera meningitidis. The target for this bug is the endothelial cell. But the person is typically dying sick with this and it is disseminated, not localized as we see here.
• Rickettsia organisms. As with N. meningitidis the target is the endothelial cell. This bug is a good possibility. Typically the infection is generalized, but it's got to start somewhere.
• Spirochetal disease such as syphilis and Borrelia infections. Again, the target is the vascular system. These both have a disseminated stage, but in the early phases are localized.