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A
13-year-old boy was admitted because of fever, anemia, hepatosplenomegaly
and multiple petechial hemorrhages. The bone marrow aspiration revealed
many myeloblasts and monoblasts. He was diagnosed as AML (M4) and
was given induction chemotherapy, consisted of vincristine, prednisolone,
adriamycin and cytosine arabinoside for two weeks. He developed febril
neutropenia (absolute neutrophil count 450/mm3) and was given intravenous
penicillin, ceftazidime and amikacin. While he was on these three
antibiotics he developed generalized erythematous papules, some with
hemorrhagic spots on top as in figure 1,2. His absolute neutrophil
count
at that time was 0. the diagram of the course is in figure 3. |
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