A generalized purpuric eruption with histopathologic features of leucocytoclastic vasculitis in a patient severely ill with COVID‐19

Caputo, V.; Schroeder, J.; Rongioletti, F.

A 59‐year‐old man was admitted to hospital for a severe respiratory failure and then intubated due to worsening of his respiratory condition. During his hospital stay, he received multiple empirical broad spectrum antibiotics (cefepime, piperacillin/tazobactam, linezolid, gentamicin and meropenem plus amikacin). The patient had no known history of drug allergies. A test to detect SARS‐CoV‐2 by real‐time reverse‐transcription‐polymerase‐chain‐reaction (RT‐PCR) assay of a throat swab was positive. Blood cell count showed severe eosinophilia (from 1,3 to 4.60 x 10) that decreased abruptly to 0.47 x 10 after introduction of methylprednisolone 1 mg/kg/day. On day 35 post admission, while on therapy only with corticosteroids, he developed a symmetrically distributed maculopapular purpuric exanthema on the face, trunk and extremities (Fig.1 a,b). Mucous membranes were spared.