A 52 year old female presented with a fever of 39⁰ C, painful hyperpigmented skin lesions, malaise, sore mucosae and dysphagia of 1 week's duration. There were palpable painful large inflammatory nodules in the involved skin areas. Laboratory findings were ESR 127/132, Ht 39%, WBC 23.600/μL (neutrophils 74% with some degree of hypogranulation and vacuolation) and diffuse hypergammaglobulinemia. Bone marrow aspiration revealed hyperplasia of the granulocytic series. Despite the intensive antibiotic therapy applied, the outcome was fatal a few days following admission, in a picture of septic shock. Fungi were detected in blood cultures.

	Peripheral blood, neutrophils with hypogranulation and vacuolation
	Bone marrow with hyperplasia of the granulocytic series and hypogranulation
	Bone marrow, MPO reaction
	Bone marrow, Sudan black B reaction
	Peripheral blood, alkaline phosphatase (LAP) reaction