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September 1990

Unilateral Cutaneous Emboli of Aspergillus

Author Affiliations

From the Department of Dermatology (Drs Watsky and Bolognia) and Pathology (Dr Eisen), Yale University School of Medicine, New Haven, Conn.

Arch Dermatol. 1990;126(9):1214-1217. doi:10.1001/archderm.1990.01670330094015

• A 40-year-old white woman with acute nonlymphocytic leukemia, which relapsed despite bone marrow transplantation and various chemotherapeutic regimens, developed fever and neutropenia. Her fever was unresponsive to broad-spectrum antibiotics, and on hospital day 53 she developed purpuric macules with necrotic centers on her left hand and forearm. Frozen sections of lesional skin were stained with Grocott's methenamine-silver and showed hyphae consistent with a species of Aspergillus; culture of the skin biopsy specimen yielded a pure culture of Aspergillus flavus. Localization of the emboli to the left upper extremity was subsequently explained by magnetic resonance imaging scan of the chest demonstrating invasion of the left subclavian artery by a pulmonary aspergilloma.

(Arch Dermatol. 1990;126:1214-1217)

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