Cutaneous Aspergillosis and Acquired Immunodeficiency Syndrome

Abstract

Background: Primary cutaneous aspergillosis is an uncommon finding in patients with acquired immunodeficiency syndrome (AIDS); only 13 cases have been reported in the literature. Observations: We describe 11 patients with primary cutaneous aspergillosis and AIDS. There does not seem to be an age, sex, race, or human immunodeficiency virus risk factor predisposition. This is a late manifestation of AIDS; patients typically have low CD4 counts (Ͻ0.050 ϫ 10 9 /L [Ͻ50/µL]) and other AIDS-defining illnesses. The most frequent presentation is in patients with cytomegalovirus disease and neutropenia caused by ganciclovir therapy. Lesions developed at the site of occlusive dressings for an indwelling intravenous catheter site

Soft Tissue Abscess Caused by Aspergillus Fumigatus in an Immunosuppressive Patient

“…Risk factors for invasive aspergillosis include neutropenia, glucocorticoid therapy, advanced acquired immunodeficiency syndrome, chronic granulomatous disease, hematopoietic stem cell or solid-organ transplantation (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19). Aspergillus infections are also common in premature and newborn infants hospitalized in intensive care according to the literature (20,21).…”

Primary aspergilloma and subacute invasive aspergillosis in two AIDS patients

“…It is interesting to note that aspergillosis can manifest clinically following resolution of neutropenia (regardless of HIV status) 14,22 . The presence of cytomegalovirus, incidentally found in the lung of the first patient, has also been implicated in the development of pulmonary aspergillosis 18,26 .…”

“…Invasive aspergillosis less frequently involves the sinuses, orbit, eye, heart or other viscera 8,13,17,19,25 . Primary cutaneous lesions 2,14 and isolated tracheobronchitis 23 have been reported. A previous study reported aspergillosis diagnosed between 10 and 26 months following onset of AIDS; despite anti-fungal therapy, these patients died within two to four months 6 .…”

Primary cutaneous opportunistic mold infections in a pediatric population

“…11 This may occur either at the site of the intravenous needle itself, under tape, or under adjoining armboards, both in children 4,[15][16][17]19,21,27 and in adults. 3,12 Such infections may also occur at central venous access sites, 3 or as a result of contaminated elastic bandages used over operative sites. 5 Contamination of equipment has been confirmed in some of these cases, as in a roll of tape, 28 wooden tongue depressors used to construct splints, 29 from the outsides of packages of medical supplies, 30 or in sterile unopened packages.…”

“…Published case series of cutaneous mold infections from an individual institution have focused on primarily adult populations. 6,[8][9][10][11][12] In the pediatric population, descriptions of cutaneous mold infections have mainly taken the form of case reports [13][14][15][16][17] or reviews of the literature. 18,19 Although Rowen et al 20 Texas Children's Hospital (TCH) in Houston is a quaternary care hospital and has the largest number of beds of any pediatric hospital in the country.…”