Manifestation of Lower Extremity Petechiae in the Presence of Septicemia

Lead Presenter

Supporting Presenters

Gan Golshteyn, DPM
Jean Holewinski, DPM
Marie L. Williams, DPM

Presented At


The purpose of this case study is to review the manifestation of lower extremity petechiae in the presence of septicemia. In this case, a 57-year-old Caucasian male with past medical history of GSW to the spine (childhood) with residual of left side weakness, alcoholism, and everyday tobacco use. The patient presented to hospital complaining of a painful left shoulder and chronic ulceration to the left plantar foot. Patient attributed the re-ulceration of this chronic wound to his foot due to the residual clubfoot deformity from the progressive left-sided weakness. Patient’s source of infection was due to an abscess in the psoas muscle belly on the right side. Patient had questionable history of drug abuse which patient denied. During physical examination of the lower extremities, patient was noted to have bilateral petechial rash with the right be worse. Course of treatment was percutaneous drainage of the abscess by Interventional Radiology and intravenous antibiotics. The petechial rash immediately resolved fours days after the first drainage of the purulent abscess. In conclusion, although the lower extremities appeared as though the source of infection was due to the chronic ulceration in this patient, the origin of the patient’s petechial/purpuric rash was the abscess in the psoas muscle. Podiatry was consulted to evaluate if source of infection was due the chronic ulceration; however, after through workup there was no identifiable source in the lower extremities.

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