Klebsiella pneumoniae Induced Leukocytoclastic Vasculitis

Leukocytoclastic vasculitis (LCV) is an immune-mediated single-organ vasculitis. It is a self-limiting disorder. Common triggers are drugs, infections, malignancy, or underlying autoimmune conditions. Here we discuss the case of an obese, middle-aged hypertensive female who presented with painful right lower limb swelling and productive cough for the last 5 days. She underwent medical and surgical management and was treated as a case of cellulitis with bilateral pneumonia. During the treatment course, she developed a nonblanchable petechial rash, which initially was attributed to the antimicrobial agent (piperacillin-tazobactam), but the culture report of the purulent sputum provoked the broadening of the differential diagnoses to include alternate causes for the rash, which proved to be a diagnostic dilemma.