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Roentgenogram of the left knee revealing a hinged knee with plate and screws in the tibia as well as intramedullary rod in the fibula.
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After completing antimicrobial treatment with vancomycin, ertapenem and fluconazole, he underwent reimplantation using a rotating hinged knee arthroplasty in September 2005 (Fig. 1).
Bilateral lower extremities showing diffuse blue-gray skin hyperpigmentation; a healed incision is noted over the left knee.
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When he was seen again in June 2016, there was extensive blue-gray pigmentation in both cheeks and in the lower extremities (Fig. 2), as well as sub-ungual blue-gray pigmentation in both hands (Fig. 3).