PMC9899103_01
An open fracture of the left lower leg with soft tissue infection
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FIG1
In addition, an open fracture of the left lower extremity caused soft tissue infection as a route of infection and caused sepsis (Figure 1).
Purpura and ulcers on the back
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FIG2
On the ninth hospital day, we conducted a skin biopsy of the purpura and ulcers on the back to identify the cause of capillary leak syndrome (Figure 2).
Skin biopsy. Hematoxylin and eosin stain showing necrotizing vasculitis. Pathology findings include inflammatory cell infiltrates, such as polymorphonuclear leukocytes and edema in some areas of the shallow dermis, and fibrin deposition and inflammatory cell infiltration in some small vessels' walls (black arrows).
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FIG3
Histopathological examination of the skin revealed active vasculitis (Figure 3).
Pelvic computed tomography showing free air just below the abdominal wall (red arrows) and between the small intestine (white arrows)
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FIG4