AN ATYPICAL THORACIC ERYSIPELAS REVEALING A PLEURAL MALIGNANT MESOTHELIOMA

We report the case of a middle-aged woman who presented with a localiz ed, well-circumscribed erythematous eruption on the right lower axilla ry chest wall that had been present for several weeks and was associat ed with local pain. The investigation revealed an infected right pleur al collection underlying the eruption, and Streptococcus mitis was iso lated from the puncture fluid. After an unsuccessful three-week parent eral antibiotic course, a right thoracotomy was performed, revealing t he presence of a malignant pleural mesothelioma. The cutaneous eruptio n regressed totally thereafter. It is thought that this cutaneous lesi on represented an atypical erysipelas related to an underlying empyema and mesothelioma. This empyema probably resulted from the infection o f a neopolastic pleural collection associated with the mesothelioma. T o our knowledge, the association of an erysipelas overlying a malignan t pleural has never been reported.