Cutaneous aspergillosis in a lung transplant recipient

Organ transplant recipients are at increased risk for Aspergillus infections. Cutaneous aspergillosis (CA) occurs less frequently and is poorly characterized. The case of a lung transplant recipient with CA is presented. Six months after transplantation, 3 painful skin nodules appeared, with 1 each in the right calf, left arm, and upper back. Exudate from the leg nodule yielded Aspergillus fumigatus. Computed tomography of the chest showed bilateral hilar lymphadenopathy, but <1 cm in size. The case could be the result of Aspergillus dissemination from a hypothetical asymptomatic pulmonary infection. The lack of lung radiological signs could be related to prophylactic treatment with inhaled liposomal amphotericin B, which could have prevented clinically evident Aspergillus lung infection. The patient was treated with voriconazole, which was maintained for 3 months. The patient recovered completely.