May 1986

The Value of Skin Biopsies in Febrile, Neutropenic, Immunocompromised Children

Author Affiliations

From the Division of Infectious Diseases, Department of Pediatrics (Drs Allen and Prober), and the Department of Pathology (Dr Smith), The Hospital for Sick Children, The University of Toronto Faculty of Medicine. Dr Prober is now with the Stanford (Calif) University Medical Center.

Am J Dis Child. 1986;140(5):459-461. doi:10.1001/archpedi.1986.02140190069028

• We assessed the value of 41 skin biopsy specimens obtained from 32 immunocompromised patients with fever and neutropenia. Fifty-six percent (23/41) of these biopsy specimens resulted in a specific diagnosis. These diagnoses included infection in 12 cases, graft-vs-host disease in nine, leukemic infiltrate in one, and drug reaction in one. The remaining 18 biopsy specimens showed either nonspecific changes or normal tissue. The infectious agents identified included Aspergillus in nine patients, Candida in three patients, and Staphylococcus aureus in one patient. As a result of the biopsy findings, therapy was altered in 49% (20/41) of the cases. The most frequent therapeutic change was initiation of amphotericin B for a demonstrated fungal infection. We found skin biopsies to be a valuable diagnostic tool in the assessment of the febrile, neutropenic, immunocompromised patient with skin lesions.

(AJDC 1986;140:459-461)