Pustular Secondary Cutaneous Aspergillosis in an Immunosuppressed Patient

Fonda‐Pascual, Pablo; Fernández-González, P.; Moreno‐Arrones, O.M.; Miguel‐Gomez, Laura

doi:10.1016/j.adengl.2018.02.011

Cited by 1 publication

(2 citation statements)

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“…There are no typical clinical features of IA skin lesions, which generally occur at previous wound sites, including intravenous catheter and adhesive tape sites [5]. Findlay et al [3] described five non-exhaustive secondary aspergillosis patterns: multiple persistent maculo-papules with a tendency to suppurate, vegetate, or necrotize; erythematous eruptions and toxicodermas; confluent granulomata with papules and nodules; a solitary necrotizing dermal plaque; and subcutaneous granuloma or abscess.…”

Section: Cutaneous Invasive Aspergillosismentioning

confidence: 99%

“…It may be a primary event resulting from direct inoculation of the Aspergillus species into the skin injury sites or secondary, either by contiguous extension from adjacent infected structures or by blood-borne dissemination of hyphae, most commonly following a primary pulmonary focus [4]. A recent review of the literature reveals only a few published cases of secondary CIA, most of which are associated with hematologic disorders and organ transplants [5][6][7][8][9][10][11][12]. The association of cutaneous and pulmonary aspergillosis with Behçet's disease (BD) is scarcer and has been previously described in two adult patients-a Japanese male patient, in whom the diagnosis was made at postmortem [13], and a Chinese adult patient in 2019 [14].…”

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confidence: 99%

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Secondary cutaneous aspergillosis in a child with Behçet’s disease: a case-based update

et al. 2023

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Background Invasive aspergillosis (IA) is one of the rarest opportunistic fungal infections and has increased in frequency worldwide in recent years. It is a life-threatening infection associated with high mortality rates. Invasive pulmonary aspergillosis (IPA) is the most severe form of the disease. Extrapulmonary forms can develop as a primary infection or occur as part of a disseminated infection from the lung in severely immunocompromised patients. The major limitation in the management of these infections is the challenge of early diagnosis. Case presentation Here we report a case of secondary cutaneous aspergillosis that developed from extensive pulmonary aspergillosis in a 3-year-old female who underwent immunosuppressive therapy for a diagnosed Behçet disease (BD). Aspergillus hyphae were identified on skin biopsies. Cultures grew Aspergillus fumigatus. The diagnosis of cutaneous aspergillosis enabled us to diagnose IPA, although there was no mycopathological proof of lung infection. The patient was successfully treated with voriconazole (8 mg/kg/day) and surgical debridement of the skin lesion. Conclusions Although cutaneous involvement in aspergillosis is extremely uncommon, it may be the presenting feature in some cases, allowing for an accurate and timely diagnosis of deeply infected sites. Accordingly, when evaluating skin lesions in immunocompromised individuals, especially debilitated children with underlying diseases requiring long-term immunosuppressive agents, cutaneous aspergillosis should be vigilantly considered.

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Section: Cutaneous Invasive Aspergillosismentioning

confidence: 99%