DOI: 10.1128/JCM.36.11.3115-3121.1998
Article Figures & Data
Figures
- Fig. 1.
Nodular cutaneous aspergillosis in a patient with AIDS. The patient had two nodules on the right forearm that arose under an occlusive dressing distal to a previous peripherally inserted central catheter. One of the lesions had been excised by biopsy, and residual sutures are present. The biopsy specimen grew A. fumigatus.
- Fig. 2.
Multiple cutaneous lesions on the leg of a bone marrow transplant recipient who had disseminated aspergillosis. Cultures of both a skin biopsy specimen and blood grew A. fumigatus.
Tables
- Table 1.
Primary cutaneous aspergillosis in HIV-infected patientsa
Reference Neutropenia CD4 count (cells/mm3) Lesion morphology Species Classification Treatment Treatment response Patient outcome 29 ND ND ND ND ND None Not applicable Not applicable (autopsy specimen) 30 No ND Umbilicated papule A. fumigatus Catheter tape associated Local, no antifungal Some lesions involuted; one cutaneous biopsy site recrudesced in the week prior to death Patient died 4 months later of CNS CMV, with 2-cm focus of pulmonary aspergillosis 30 ND ND Umbilicated papule ND Catheter tape associated None (fluconazole) Biopsy sites healed, no new lesions Patient died several months later of disseminated MAC 54 No 67 Verrucous plaque with micropustules A. fumigatus Catheter associated Amphotericin B at 0.6 mg/kg/day i.v. for 14 days and local wound care Modest decrease in lesion size Patient died 3 months later after gradual decline 21 No 24 Indurated erythema A. fumigatus Catheter associated Itraconazole at 200 mg/day and catheter removal for 25 days, then replaced by amphotericin B at 1.0 mg/kg/day i.v. Cutaneous infection progressively improved Amphotericin B added 4 weeks later when pulmonary lesions cavitated; patient died 2 weeks later 57 No 143 Ulcer A. glaucus Trauma wound associated Amphotericin B at 1.0 mg/kg/day i.v. for 4 days and surgical debridement, then itraconazole at 200 mg p.o. b.i.d. for 6 months Lesion resolution No subsequent aspergillosis 58 No ND Pruritic, exophytic lesion A. fumigatus Catheter, transparent tape associated ND ND ND 57 Yes 2 Nodule A. fumigatus Catheter associated Amphotericin B at 1.0 mg/kg/day i.v. for 19 days and surgical debridement, then skin graft Lesion resolution No subsequent aspergillosis 63 Yes 15 Nodule A. fumigatus Catheter tape associated Itraconazole at 200 mg p.o. b.i.d. for 9 weeks Lesion resolution No subsequent aspergillosis 63 Yes 0 Nodule A. fumigatus Catheter tape associated Itraconazole at 200 mg p.o. b.i.d. for 4 weeks Lesion excised by biopsy, then possibly recrudesced off therapy Patient died of wasting within 1 month of recrudescence of skin lesion ↵a Abbreviations: ND, no data; CNS CMV, central nervous system cytomegalovirus; MAC, M. aviumcomplex; i.v., intravenously; p.o., orally; b.i.d., twice daily.
