Cutaneous Aspergillosis Research Articles

PRIMARY CUTANEOUS ASPERGILLOSIS IN A 13-YEAR-OLD BOY WITH BONE MARROW APLASIA: CASE REPORT

Cutaneous aspergillosisis a rare condition, and while rare in immunocompetent individuals, it predominantly affects immunosuppressed patients, particularly those with hematological-oncological disorders within the pediatric demographic. Herein, we present a 13-year-old boy under follow-up for bone marrow aplasia. The child developed long-lasting fever and papulous and ulcerous indurated skin lesions on his whole body. Blood count showed agranulocytosis with neutrophils count of 10/μl. Thoracic, abdominal and pelvic Computed Tomography (CT) scan has revealed bilateral alveolar syndrome in the lungs. Skin biopsy revealed cutaneous aspergillosis. Despite treatment, the boys condition did not improve, and he passed away 2 weeks following his hospital admission because of septic shock. Cutaneous aspergillosis is due to Aspergillus flavus and A. fumigatus, for primary and secondary (invasive) cases, respectively. The rapid progression of this disease from the initial cutaneous infectious region necessitates prompt medical intervention to avoid increasing the risk of mortality. This condition typically manifests after the fungus is directly inoculated through skin contact with contiguous infected areas or via hematogenous spread from a remote mycotic site to the skin.

Primary Cutaneous Aspergillosis in an HIV Patient and Combined Therapy: A Case Report

Primary cutaneous aspergillosis (PCA) is a rare disease caused by a few pathogenic species of Aspergillus. It manifests in immunocompromised patients as different types of localised lesions, the treatment has evolved and the latest reviews ensure better results with a combined therapy. We present a 27-year-old male gardener with a history of human immunodeficiency virus infection and a nodular presentation of PCA. He received surgical and antifungal medication, showing a good response and no dissemination or recurrence of the disease.

Manifestations, Prevalence, Management and Outcome of Invasive Aspergillosis in Post-Liver Transplant Patients.

Aspergillosis is a severe and fatal complication that causes infection in transplant recipients and patients with immunodeficiency syndrome, neutropenia, chronic granulomatosis, and hematologic malignancies. Invasive Aspergillosis has been reported as one of the fungal infections with high mortality in transplant recipients. This study aimed to describe the manifestations, prevalence, management and outcome of invasive Aspergillosis fungal infections in liver transplant patients. This descriptive cross-sectional study was conducted on patients with liver transplantation who were infected with invasive Aspergillosis fungal infections. The data were extracted from the medical records of the archive of Montasryieh Hospital, Mashhad, Iran, between August 2019 and August 2020. In general, 86 patients who had liver transplantation were hospitalized at Montasryieh Hospital from August 2019 to August 2020. Among them, 10 patients were infected with invasive Aspergillosis. Only 6.7% of the patients were categorized under late-onset (> 90 days after liver transplantation), and 93.3% of them were early-onset (< 90 days after liver transplantation). Invasive Aspergillosis fungal infections were suspected based on clinical or radiological signs (possible in 30% of cases; n = 3). The probable diagnosis was reported in 60% (n = 6), and the proven diagnosis was observed only in one patient. In addition, 80% of the patients were diagnosed with Pulmonary Aspergillosis, and two patients had pulmonary Aspergillosis in combination with the central nervous system and cutaneous Aspergillosis. A correlation was found between a comorbid disease and the type of Aspergillosis (r = 0.69; P = 0.02). Voriconazole was effective to treat invasive Aspergillosis in all patients. The prevalence rate of Aspergillosis is relatively high among liver transplant recipient populations (11%). All recipients infected with Aspergillosis had at least one risk factor, including an underlying disease. It seems that Voriconazole therapy is effective among transplant patients with pulmonary Aspergillosis.

Primary cutaneous aspergillosis presenting as a cystic lesion in the foot

Aspergillosis is a fungal infection, usually affecting the lungs, mostly in immunocompromised patients. Musculoskeletal or cutaneous involvement is extremely rare and when it does occur, the diagnosis and treatment is delayed. We present a case of primary cutaneous aspergillosis presenting as a cyst in the foot of a 54-year-old immunocompetent female. She presented with the complaint of painful lump over right foot at the region of the fourth webspace. Magnetic Resonance Imaging (MRI) was suggestive of infected ganglion cyst. However, histopathological examination showed granulomas with areas of caseous necrosis and silver stain showed multiple fungal hyphae with morphology suggestive of Aspergillus species.

Primary Cutaneous Aspergillosis Caused by Aspergillus ochraceus.

Primary Cutaneous Aspergillosis Caused by Aspergillus ochraceus.

Epidemiology of Clinically Significant Aspergillus Species from a Large Tertiary Hospital in Shanghai, China, for the Period of Two Years.

Aspergillus species are becoming a major public health concern worldwide due to the increase in the incidence of aspergillosis and emergence of antifungal resistance. In this study, we surveyed all Aspergillus species isolated from aspergillosis patients in Zhongshan Hospital Fudan University, Shanghai, China, from 2019 to 2021. We characterized the susceptibility profiles of these Aspergillus species to medical azoles (voriconazole, itraconazole and posaconazole) using YeastOneTM broth microdilution system. To determine the underlying antifungal resistance mechanisms in azole-resistant A. fumigatus (ARAf) isolates, we characterized mutations in the cyp51A gene. Genotypic diversity of sampled A. fumigatus was investigated using CSP-typing. A total of 112 Aspergillus isolates (81 A. fumigatus, 17 A. flavus, 5 A. niger, 2 A. terreus, 2 A. lentulus, 2 A. oryzae, 1 A. nidulans, 1 A. versicolor and 1 A. sydowii) from 105 patients diagnosed with aspergillosis (including proven or probable invasive aspergillosis, chronic pulmonary aspergillosis, allergic bronchopulmonary aspergillosis and cutaneous aspergillosis) were obtained. Eight isolates (7 A. fumigatus and 1 A. niger) from seven patients were either azole non-susceptible or non-wild type. Azole non-susceptible or non-wild type rate was 7.1%/isolate and 6.7%/patient analysed. Four ARAf harbored TR34/L98H mutation, whereas one carried TR46/Y121F/T289A allele. The 81 A. fumigatus isolates were spread across 8 CSP types with t01 to be the predominant type (53.1%). ARAf isolates were distributed over CSP types t01, t02, t04A and t11. Results from this study provided us with an understanding of the antifungal resistance and related characteristics of Aspergillus species in Eastern China. Further comparisons of our results with those in other countries reflect potential clonal expansion of A. fumigatus in our region. Further surveillance study is warranted to guide antifungal therapy and for epidemiological purposes.

Cutaneous aspergillosis in a diabetic patient- A cytological encounter in FNAC

Diabetes mellitus is a public health problem significantly contributing to morbidity and mortality worldwide. The patients are highly prone to opportunistic infections with major systemic as well as cutaneous fungi. The fungal infections frequent in diabetics include Candidiasis as well as cutaneous Aspergillosis. The most commonly involved species include Aspergillus niger, Aspergillus flavus and Aspergillus fumigatus. Presenting here is a case of 60 years male with history of diabetes mellitus type 2 on oral hypoglycaemic agents, presenting in Medicine Out Patient Department with complaints of progressive painless left cystic medial ankle swelling for last 4 months. Patient was then asked to undergo FNAC which revealed pyogenic inflammation with giant cells and fungal hyphae showing acute angled branching. Furthermore, microbiological confirmation was also done and patient was initiated treatment for the same. This case report underlines the importance of FNAC and Cytological study in the accurate and early diagnosis of Cutaneous Aspergillosis even before the more expensive and time-consuming microbiological diagnostic modalities are applied.

Primary Cutaneous Aspergillosis Caused by Aspergillus flavus in a Premature Infant.

Primary Cutaneous Aspergillosis Caused by Aspergillus flavus in a Premature Infant.

Primary Cutaneous Aspergillosis in an Immunocompetent Host Presenting as Ulcero-Proliferative Escharotic Lesion

Primary Cutaneous Aspergillosis in an Immunocompetent Host Presenting as Ulcero-Proliferative Escharotic Lesion

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

BackgroundInvasive 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 presentationHere 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.ConclusionsAlthough 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.

Brownish-Yellow Layering on Skin—an Unusual Manifestation of Cutaneous Aspergillosis in a Heart Transplant Recipient

An unusual cutaneous manifestation of aspergillosis in an immunocompromised patient in which Aspergillus terreus grew on the necrotic skin, creating a brownish-yellow layer of fungal growth, is reported.

A mould in the fold should never grow old: cutaneous aspergillosis in a preterm neonate

A boy born at 25 weeks of gestation (birth weight 560 g) due to feto-fetal transfusion syndrome (mono-chorionic, di-amniotic gemini) was noticed on his ninth day of life to have multiple skin lesions on the abdomen, buttocks, and thighs (Figure 1A, B). The mother and his twin brother had no apparent skin abnormalities. Microbiological cultures from skin swabs and scrapings yielded growth of moulds, suggestive of Aspergillus species (Figure 1C-G). Matrix assisted laser desorption/ionization time-of-flight mass spectrometry confirmed Aspergillus fumigatus.

Primary invasive cutaneous aspergillosis: A rare but fatal course in an extremely preterm triplet.

A male triplet was born at our hospital at 24 + 2 gestational weeks (birth weight of 400 g) due to premature labor. Antibiotic therapy with antifungal prophylaxis was started upon admission. He was treated with hydrocortisone at low doses (0.5–1.5 mg/kg per day) during the first 3 days of his life. Antibiotic therapy was continued with vancomycin after the Staphylococcus epidermidis appearance in the blood culture on Day 3. On Day 5, he presented with singular, localized, tiny white pustules in the inguinal region.

Primary cutaneous aspergillosis in an immunocompetent individual

&lt;p class="abstract"&gt;Aspergillosis is an uncommon fungal infection in which primary cutaneous sites are very rare. Most cases occur in immunocompromised patients and infection in immunocompetent patients, is extremely rare, but an increase in prevalence has been noted in last 20 years. A case of primary cutaneous aspergillosis (PCA) in a 40-year-old immunocompetent shopkeeper resident of Jaipur Rajasthan presenting with verrucous growth on the lower lip has been reported in this case study.&lt;/p&gt;

Aspergillus wound infection in an immune-competent patient – A case report

• Abdominal surgical site aspergillosis can be seen in an immunocompetent patient. • Surgical site aspergillosis is a form of cutaneous aspergillosis. • Prevention of surgical site aspergillosis combines clinical and environmental considerations. • Therapy involves medical and surgical approach for optimal outcomes. Abdominal aspergillosis is a life-threatening, opportunistic fungal infection that mainly affects immunocompromised patients. In this report, we present a case of abdominal surgical site aspergillosis in an immunocompetent patient. A 74-year-old immune-competent woman that had a prolonged hospitalization in the Intensive Care (ICU) Unit with several abdominal surgeries and multiple antibiotic treatment regimens. The abdomen remained open between interventions. 21 days following ICU admission a diagnosis of surgical site aspergillosis was made, treated with systemic and topical antifungal treatment. While nosocomial aspergillosis typically affects immunocompromised patients, immunocompetent patients also become susceptible when the skin barrier is broken and tissue is exposed to the environment. Treatment consisted with surgical debridement and systemic antifungal therapy. This case provides an example of extensive and rare surgical infection.

Aspergillus fumigatus as an agent of secondary cutaneous aspergillosis in a renal transplant recipient: a case report

<i>Aspergillus fumigatus</i> as an agent of secondary cutaneous aspergillosis in a renal transplant recipient: a case report

A Rare Case of Primary Cutaneous Aspergillosis of the Scalp in an Immunocompetent Patient

Aspergillosis is a rare invasive fungal infection caused by numerous species of aspergillus. Few species of Aspergillus are pathogenic in human existence. The most frequent are aspergillus fumigatus and flavus [1]. Cutaneous aspergillosis remain an uncommon form, it may be primary, affecting the site of skin trauma or secondary due to hematogenous spread from a contiguous anatomic location [2]. Here we describe a rare case of primary cutaneous aspergillosis located on the scalp in an immunocompetent host, which continue to be undiagnosed for a long period of time by dermatologists.

Cutaneous Aspergillosis As a First Manifestation of Systemic Infection in Patient After Kidney Transplantation.

Cutaneous Aspergillosis As a First Manifestation of Systemic Infection in Patient After Kidney Transplantation.

超低出生体重児に生じた原発性皮膚アスペルギルス症の1例

超低出生体重児に生じた原発性皮膚アスペルギルス症の1例

Diagnosis and Treatment of Cutaneous Aspergillosis

Aspergillosis is an opportunistic mycosis caused by fungi in the genus Aspergillus, mostly A. fumigatus and A. flavus. Typical entry portals in primary cutaneous aspergillosis include burns, trauma sites, surgical wounds, intravenous catheters, and macerated skin in underlying occlusive dressings. In individuals who are immunocompromised, the dissemination risk is significant. Skin findings range from firm papules and necrotic papulonodules to hemorrhagic bullae and ulcers. The prognosis is poor but improves when the patient is no longer neutropenic or when corticosteroids are discontinued. Localized primary cutaneous aspergillosis can be excised surgically, followed by oral antifungal administration. For the first-line treatment of pulmonary invasive aspergillosis, isavuconazole and voriconazole are the preferred agents, whereas liposomal amphotericin B is supported moderately.