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Image 14:
In Lima, a Peruvian 32 year old, with a fever, a 4 day history of a painful left arm, painful warm 5x10 cm. mass in the axilla and these painless ulcers (the larger 0.5 cm) on the left forearm.
Diagnosis:
This was anthrax (Bacillus anthracus) confirmed by culture. The peri-eschar vesciculation was a helpful clue. He had recently helped with the slaughter of goats, pigs. He responded to doxycycline.
