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Neonatal Cutaneous Invasive Aspergillosis Accompanied by Hemophagocytic Lymphohistocytosis

Chen, Zhuanggui MD, PhD; Yang, Lifen MD, MSc; Li, Yating MD, MSc; Pan, Li MD, MSc; Li, Meirong BSc; Al-Hatmi, Abdullah M.S. MSc; Meis, Jacques F. MD, PhD; Lai, Wei MD, PhD; Feng, Peiying MD, PhD

Pediatric Infectious Disease Journal: April 2017 - Volume 36 - Issue 4 - p 423–425
doi: 10.1097/INF.0000000000001463
Instructive Case

We describe a 6-week-old female infant with cutaneous invasive aspergillosis accompanied with hemophagocytic lymphohistocytosis. Aspergillus flavus was isolated from biopsies of necrotic skin lesions on the forehead and scalp; morphologic identification was confirmed by molecular analysis. In vitro antifungal susceptibility testing showed that amphotericin B and triazoles had potent activity. The patient responded well to treatment with intravenous amphotericin B combined with oral posaconazole and local wound care. The hemophagocytic lymphohistocytosis abated after treatment of cutaneous aspergillosis. Both cutaneous invasive aspergillosis and hemophagocytic lymphohistocytosis are severe disorders with high morbidity and mortality requiring prompt diagnosis and treatment.

From the *Department of Pediatrics and Department of Dermatology, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China; Institute of Biodiversity and Ecosystem Dynamics, University of Amsterdam, Amsterdam, the Netherlands; CBS-KNAW Fungal Biodiversity Centre, Utrecht, The Netherlands; Directorate General of Health Services, Ibri Hospital, Ministry of Health, Oman; and §Department of Medical Microbiology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands; Department of Medical Microbiology and Infectious Diseases, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands.

Accepted for publication September 27, 2016.

This work was supported by the Young Teacher Foundation of Sun Yat-sen University (No. 13ykpy32 to Peiying Feng).

The authors have no conflicts of interest to disclose.

Address for correspondence: Peiying Feng, MD, PhD, Department of Dermatology, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China. E-mail: fpying77@gmail.com

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