2004 Volume 66 Issue 2 Pages 132-134
A 69-year-old woman presented at our outpatient clinic with burning pain, swelling and local heat on her left ankle. Our initial diagnosis was phlegmon on the basis of surgical aspiration with suspected bacterial infection. However, clinical manifestations were not consistent with this diagnosis. Her body temperature remained normal and laboratory tests did not reveal any infectious sign. We administered oral antibiotics and undertook further intensive laboratory examinations. Subsequently, cryoglobulinemia was demonstrated through polyclonal IgG and IgM that were revealed by immunoblotting analysis. Our final diagnosis was type III cryoglobulinemia masquerading as phlegmon. We speculate that this patient had repeatedly cooled her ankle with a cold epithem, resulting in phlegmon-like lesion. We would like to propose care in excluding a diagnosis of cryoglobulinemia in an HCV career.
