A Case of Disseminated Aspergillosis Presenting Solely as Multiple Cutaneous Lesions in an Acute Leukemia Patient

Jin-Hee No; Jin-Sok Yu; Eun-Ok Kim; Hyun-Ho Choi; Si-Hyun Kim; Jae-Cheol Kwon; Dong-Gun Lee; Su-Mi Choi; Sun-Hee Park; Jung-Hyun Choi; Jin-Hong Yoo; Hee-Je Kim; Woo-Sung Min

doi:10.3947/ic.2010.42.4.244

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No, Yu, Kim, Choi, Kim, Kwon, Lee, Choi, Park, Choi, Yoo, Kim, and Min: A Case of Disseminated Aspergillosis Presenting Solely as Multiple Cutaneous Lesions in an Acute Leukemia Patient

Case Report

Infection & Chemotherapy

Infection & Chemotherapy 2010; 42(4): 244-248.

Published online: 30 August 2010

DOI: https://doi.org/10.3947/ic.2010.42.4.244

A Case of Disseminated Aspergillosis Presenting Solely as Multiple Cutaneous Lesions in an Acute Leukemia Patient

Jin-Hee No, Jin-Sok Yu, Eun-Ok Kim, Hyun-Ho Choi, Si-Hyun Kim, Jae-Cheol Kwon, Dong-Gun Lee

, Su-Mi Choi, Sun-Hee Park, Jung-Hyun Choi, Jin-Hong Yoo, Hee-Je Kim, Woo-Sung Min

Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.

Correspondence to Dong-Gun Lee, M.D., Ph.D. Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, #505, Banpo-dong, Seocho-gu, Seoul 137-701, Korea. Tel: +82-2-2258-6003, Fax: +82-2-535-2494, symonlee@catholic.ac.kr

Received 12 January 2010 Revised 3 July 2010 Accepted 5 July 2010

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Invasive aspergillosis (IA) is a major cause of morbidity and mortality in patients with hematological malignancies. While the development of new effective antifungals and advancement of diagnostic techniques have lead to improved outcomes, relapse of IA in patients with subsequent immunosuppression is emerging as a major issue. The primary IA site is the most common relapse site, but disseminated infection from the lung to multiple organs, including the brain, thyroid, liver, spleen, kidney, bone, heart valve, and skin, can often occur in patients with severe immunosuppression. Furthermore, relapsing or disseminated IA have very poor outcomes. We report a case of disseminated IA presenting as multiple cutaneous lesions without involvement of any other organs in an acute leukemia patient. The patient had suffered from prior invasive pulmonary aspergillosis, which was treated successfully. The multiple skin lesions were fully resolved after antifungal therapy for 6 weeks.

Keywords: Cutaneous aspergillosis, Disseminated aspergillosis, Acute myeloid leukemia

Figures and Tables

Figure 1

Photograph of the patient showing an erythema surrounding central necrotic eschar on the left forearm.

Figure 2

Punch biopsied specimen of skin shows acute and chronic inflammation with hyaline, septated, and acute-angle branched hyphae invading vessels in dermis and subcutis (A) Periodic acid Schiff (H&E stain, ×400), (B) Grocott-Gomori methenamine silver (H&E stain, ×400).

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ORCID iDs: Dong-Gun Lee
https://orcid.org/http://orcid.org/0000-0003-4655-0641
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