Primary cutaneous aspergillosis in six leukemic children

Area of Science:

• Medical Mycology
• Pediatric Hematology
• Infectious Diseases

Background:

• Primary cutaneous aspergillosis is a rare fungal infection.
• Children with hematologic malignancy are particularly susceptible to invasive fungal infections.
• Infections can arise from environmental sources, especially in healthcare settings.

Purpose of the Study:

• To describe a cluster of primary cutaneous aspergillosis in pediatric patients with hematologic malignancy.
• To highlight the diagnostic challenges and effective management strategies.
• To identify the source of infection to prevent further cases.

Main Methods:

• Case series reporting six pediatric patients.
• Clinical presentation: hemorrhagic bullae at sites of medical devices.
• Diagnostic methods: potassium hydroxide (KOH) examination of blister roof.
• Treatment: intravenous amphotericin B.
• Epidemiological investigation to identify the source.

Main Results:

• Six children with hematologic malignancy developed primary cutaneous aspergillosis.
• Lesions appeared at intravenous cannula insertion sites or where arm boards were applied.
• Rapid KOH examination facilitated early diagnosis.
• Five patients received intravenous amphotericin B; none developed disseminated aspergillosis.
• The source was traced to a contaminated storeroom with a recent water leak.

Conclusions:

• Primary cutaneous aspergillosis can manifest in immunocompromised children.
• Prompt diagnosis via KOH examination and early antifungal treatment are crucial for favorable outcomes.
• Environmental contamination control is vital in healthcare facilities to prevent outbreaks.