• Ayesha T Gittens, John-Ross D Clarke, Shady Abdelbaki, and Jeff S Kwon.
• Department of Internal Medicine, Yale-New Haven Health/Bridgeport Hospital, New Haven, CT.
• Chest. 2020 Feb 1; 157 (2): e41-e45.

Case PresentationA 72-year-old man presented to our ED less than 24 hours following the acute onset of nausea, vomiting, and diarrhea. Within 12 hours of symptom onset, he noted bilateral lower extremity pain and swelling. His pain was associated with a new violaceous irregular rash on the anterior aspect of both feet and legs. There was no history of inciting trauma or recent wounds. In addition, there was no history of consumption of raw or undercooked food (including seafood) or recent change in food source. There was accompanying fever and chills for the same duration and painful swelling of his left thumb. His comorbidities included stage IIIb classical Hodgkin lymphoma diagnosed 4 months prior. His last dose of doxorubicin, bleomycin, vinblastine, and dacarbazine chemotherapy was 4 days before presentation. He had previously failed anti-CD30 monoclonal therapy resulting from attributed pancolitis.Copyright © 2019 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

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