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Requests for reprints should be addressed to Orly Avnery, MD, Hematology Institute, Meir Medical Center, 59 Tchernichovsky Street, Kfar Saba 44281, Israel.
Sackler School of Medicine, Tel Aviv, IsraelNational Hemophilia Center and Institute of Thrombosis and Hemostasis, Chaim Sheba Medical Center at Tel Hashomer, Ramat Gan, Israel
Over days, a patient's relatively small lesion evolved into widespread tissue damage.
A previously healthy 49-year-old Arab woman was admitted for a 2-cm painful red lesion
on her left breast. She had been well until a few days earlier, when she developed
left flank pain and was treated with ofloxacin for a presumed urinary tract infection.
During the first 48 hours of her admission, the erythematous lesion over the left
breast progressed, developing the appearance of a hematoma. Ultimately, it involved
the entire breast (Figure 1). The patient denied trauma. At the same time, her hemoglobin level decreased by
2 g/dL. Her prothrombin time, partial thromboplastin time, fibrinogen concentration,
and platelet count were all within normal limits.
Figure 1The patient's left breast appeared to have an extensive hematoma with a clearly demarcated
border.