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Cutaneous zygomycosis associated with urate panniculitis
Stephen E Vernon1, Sandeep P Dave
1Department of Pathology, University of Miami Miller School of Medicine, Miami, FL 33136, USA. svernon@med.miami.edu
The American Journal of Dermatopathology
|July 28, 2006
Summary
Cutaneous zygomycosis, a severe fungal infection, was identified in a neonatal organ transplant patient. The case highlights "urate panniculitis," a novel finding of uric acid crystals in skin inflammation, crucial for early diagnosis and treatment.
Area of Science:
- Medical Mycology
- Transplant Infectious Diseases
- Dermatopathology
Background:
- Cutaneous zygomycosis is a life-threatening fungal infection in immunocompromised individuals.
- Diagnosis is challenging due to difficulties in culturing organisms from clinical samples.
Observation:
- A neonatal multi-visceral organ transplant patient presented with cutaneous zygomycosis.
- Subcutaneous panniculitis was observed, characterized by extensive local deposition of acicular uric acid crystals.
Findings:
- The crystals were identified as monosodium urate using various analytical methods.
- Microwave-based tissue processing preserved crystal integrity, aiding identification.
- Transient hyperuricemia was suspected but not definitively confirmed.
Implications:
- The study introduces the term "urate panniculitis" to describe this specific clinicopathological finding.
- Early diagnosis and prompt treatment (antifungal therapy, debridement) led to a successful outcome.
- This case underscores the importance of recognizing rare presentations of zygomycosis in transplant recipients.
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