Cutaneous aspergillosis: a report of six cases

Abstract

Skin invasion by Aspergillus is infrequent. We here describe six immunocompromised patients with skin manifestations caused by Aspergillus. A heart transplant recipient developed a primary cutaneous aspergillosis; two patients (one with chronic granulomatous disease and another treated with a high dose of corticosteroids) presented with nodular lesions secondary to haematogenous dissemination; and three patients with acute myelogenous leukaemia had skin dissemination by contiguity from orbit and sinus invasion. A. flavus was isolated in the three cases of leukaemia; the infection was due to A. fumigatus in the transplant recipient; A. fumigatus and A. versicolor were isolated in the patients with the secondary aspergillosis. In most cases, amphotericin B was useful, with clinical and mycological remission in four patients. A patient with leukaemia died without undergoing treatment, and a child carrier of chronic granulomatous disease died after only 12 days of treatment.

Severe primary cutaneous aspergillosis refractory to amphotericin B and the successful treatment with systemic voriconazole in two premature infants with extremely low birth weight

“…8,9,12 Voriconazole apparently prevented life-threatening systemic dissemination of the mold infection, resulting in a vastly improved outcome compared to previous reports on this condition in premature infants. [1][2][3][4] …”

“…[1][2][3][4] Several authors have pointed out the difficulties of an early clinical or microbiological diagnosis and have emphasized the need for an immediate and effective antifungal therapy. [1][2][3] Woodruff et al 1 reviewed 16 cases of primary cutaneous aspergillosis in neonates, eight of whom died from fulminant fungal sepsis. Classical antifungal treatment did not prevent dissemination of these mold infections, which were initially limited to skin lesions.…”

“…Classical antifungal treatment did not prevent dissemination of these mold infections, which were initially limited to skin lesions. 1,3 Although liposomal amphotericin B has been the drug of choice in these patients, [1][2][3][4] several reports indicate that a substantial fraction of Aspergillus species may be refractory to amphotericin B. 1,5,6 During the past few years, voriconazole, an extendedspectrum triazole antifungal, has become increasingly established as an agent of choice in severe fungal infections.…”

Primary Gangrenous Cutaneous Mold Infections in a Patient with Cancer and Neutropenia

“…32 Penetrating trauma remains the major cause of primary cutaneous zygomycosis (Table 2). [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] Other causes reported include elasticized bandages and wound dressings, 55 burns, 56 motor vehicle collision, 57 intravenous access, 58 and dog bite. 59 Our case report of primary cutaneous mucormycosis after a cat bite is a rare finding.…”

“…[5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] In patients with hematological malignancy and primary cutaneous mold infection, outcomes were determined on whether or not the infection was localized vs disseminated. [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] In cases in which the infection remained localized, 100% of patients recov- ered; by contrast, in cases of disseminated infection, the mortality rate was 29.4%. [5][6][7][8][9][10][11][12][13][14][15][16][17]…”