29-Year-Old Woman With Fever and Bilateral Lower Extremity Lesions

A 29-year-old woman with a history of obesity (body mass index, 39 kg/m2) and polycystic ovarian syndrome presented to her primary care physician in late spring for evaluation of fever (39.3°C), chills, and a boil on the inner thigh. She was otherwise healthy, had been feeling well, and was enjoying her weekly fishing excursions at several of the lakes in Minnesota until the day before the evaluation, when she had noted pain and induration on the medial aspect of her right upper thigh. She inserted a needle into this area, but no fluid was expressed. The pain progressed, and erythema was noted around the lesion. A similar phenomenon on the medial aspect of her left upper thigh developed; however, this was not punctured. She was given ibuprofen and ultimately directed to the emergency department for further evaluation of presumed abscesses.