Post-Partum Patient with History of Leukemia Presenting with Petechial Rash Following Mosquito Bites

Case at a Glance

A 31-year-old postpartum female with a remote history of leukemia presents with concerning petechial rash development following mosquito bites and subsequent scratching.

Patient's Story

The patient reports a 2-day history of unusual skin changes following mosquito bites. She describes developing what appears to be petechiae after scratching the bite sites. She notes this reaction is significantly different and more severe than her typical response to mosquito bites in the past. The patient expresses concern about the unusual nature and extent of the skin changes, particularly in one area that appears more severely affected than others.

Initial Assessment

31-year-old female, 7 months postpartum, height 160cm, weight 60kg. Medical history significant for leukemia treated 11 years prior. Previous medication history includes triptans for migraine management, discontinued following pregnancy. Currently not taking any regular medications. Physical examination reveals petechial rash pattern in areas of mosquito bites, with one area showing more extensive involvement.

The Diagnostic Journey

Given the patient's history of hematologic malignancy and the unusual presentation of petechiae following minor trauma (scratching), investigation would focus on current hematologic status. The postpartum period and previous leukemia history raise concerns about potential platelet dysfunction or thrombocytopenia. The atypical severity compared to previous mosquito bite reactions suggests possible underlying hematologic changes.

Final Diagnosis

Pending - requires hematologic evaluation to rule out thrombocytopenia or platelet dysfunction in the setting of postpartum status and remote leukemia history

Treatment Plan

Immediate complete blood count with platelet count and peripheral blood smear. Coagulation studies including PT/PTT. Hematology consultation given history of leukemia. Patient education regarding monitoring for additional bleeding signs or bruising. Avoidance of further trauma to affected areas.

Outcome and Follow-up

Patient advised to seek urgent medical evaluation for laboratory studies and specialist consultation. Follow-up pending laboratory results and hematologic assessment to determine if this represents a benign postpartum change or requires further investigation for possible hematologic recurrence.