Periumbilical linear thumbprint purpura preceded by pulmonary hemorrhage in an organ transplant recipient

A 60-year-old African American male on immunosuppression for recent kidney transplant, who initially complained of multiple symptoms, including laryngitis, productive cough, nausea, vomiting, diarrhea, fatigue, and rib pain, was admitted and intubated secondary to critical hemorrhagic shock from frank alveolar hemorrhage on bronchoalveolar lavage. This was initially thought to be vasculitic in nature by primary team and consultants following a broad and unremarkable workup, including BAL cultures, stains, and cytology.
Source: Journal of the American Academy of Dermatology - Category: Dermatology Source Type: research