Multiple oropharyngeal ulcerations with acute myeloid leukaemia

These are multiple ulcers on the oropharynx of a 19 year old man with acute myeloid leukaemia (fig 1).bmj;378/sep28_9/e070983/F1F1f1Fig 1He presented to the emergency department with fever, nausea and vomiting, and a sore throat that had persisted for three weeks. He had experienced dysphagia, gum bleeding after brushing his teeth, dyspnoea on exertion, fatigue, and decreased appetite. On examination he had bilateral tender posterior auricular lymphadenopathy, mucosal pallor of the buccal region, multiple ulcers, and erythema of the oropharyngeal region.Blood test results showed a white blood cell count of 149.20×109/L (reference range 4.8-10.8×109/L; 79% abnormal immature white blood cells (blasts)), haemoglobin level of 97 g/L (reference range 135-175 g/L), and platelet count of 280×109/L (reference range 130-370×109/L).Bone marrow biopsy results indicated non-promyelocytic acute myeloid leukaemia.Oral ulcers associated with acute myeloid leukaemia might result from neutropenia or direct infiltration by leukaemic cells secondary to an immunocompromised state. Blood tests should be…
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