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Solitary embolic cutaneous aspergillosis in the immunocompromised patient with acute myelogenous leukemia – a propos another case caused by Aspergillus flavus
Author(s) -
Krunic Aleksandar L.,
Medenica Maria,
Busbey Shail
Publication year - 2003
Publication title -
international journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.677
H-Index - 93
eISSN - 1365-4632
pISSN - 0011-9059
DOI - 10.1111/j.1365-4632.2003.01807.x
Subject(s) - medicine , aspergillosis , aspergillus flavus , neutropenia , pathology , leukemia , mycosis , sepsis , pneumonia , amphotericin b , chemotherapy , dermatology , immunology , antifungal , biology , microbiology and biotechnology
A 68‐year‐old male with acute myelogenous leukemia was admitted for consolidation chemotherapy. The in‐hospital course was complicated by neutropenia, fever and nodular pulmonary opacities suggestive of multifocal pneumonia. The patient subsequently developed a single, solitary necrotic crusted nodule on the right cheek. Skin biopsy demonstrated embolic vascular invasion with septate hyphae, dichotomous branching and minimal inflammation. Tissue culture revealed Aspergillus flavus . Despite systemic antifungal therapy with amphotericin B and granulocyte transfusions, the patient developed respiratory failure and died of disseminated aspergillosis, sepsis and renal failure. The clinical presentation of disseminated infection with Aspergillus flavus as a solitary embolic cutaneous lesion is extremely rare. We have reviewed other cases described in the literature and suggest this pattern of cutaneous involvement as more typical of disseminated infection with Aspergillus flavus .