pISSN 2093-2340   eISSN 2092-6448
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Open Access, Peer-reviewed
    Infect Chemother. 2010 Aug;42(4):244-248. Korean.
    Published online Aug 30, 2010.
    https://doi.org/10.3947/ic.2010.42.4.244
    Copyright © 2010 by The Korean Society of Infectious Diseases and Korean Society for Chemotherapy
    Case Report

    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 and 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, Email: symonlee@catholic.ac.kr
    Received January 12, 2010; Revised July 03, 2010; Accepted July 05, 2010.

    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

    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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    MeSH Terms
    Aspergillosis
    Brain
    Heart Valves
    Hematologic Neoplasms
    Humans
    Immunosuppression Therapy
    Invasive Pulmonary Aspergillosis
    Kidney
    Leukemia
    Leukemia, Myeloid, Acute
    Liver
    Lung
    Recurrence
    Skin
    Spleen
    Thyroid Gland
    Metrics
    Share
    Figures
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