A 52-year-old male presents with complaints of a rash and pain in his perineal area for 4 days. The rash first appeared in his upper right thigh and was purpuric with a central black discoloration. He also complained of general malaise, fever of 103°F and diarrhea for 4 days. His past history includes chronic hepatitis C, alcoholism, liver cirrhosis and substance abuse. Laboratory studies revealed leukopenia (400 per mm3) with an absolute neutrophil count (ANC) of zero. A peripheral blood smear was also taken (Figure 1).
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