Secondary cutaneous aspergillosis in a child with Behçet’s disease: a case-based update

Nachate, Soumia; El Mouhtadi, Mouad; Zouine, Yousra; Haouane, Mohamed Amine; Azami, Mohamed Amine; Saiad, Mohamed Oulad; Basraoui, Dounia; Jalal, Hicham; Nassih, Houda; Elqadiry, Rabiy; Bourrahouat, Aicha; Sab, Imane Ait; El Hakkouni, Awatif

doi:10.1186/s43159-023-00242-2

Secondary cutaneous aspergillosis in a child with Behçet’s disease: a case-based update

Authors

Abstract

Background
Invasive aspergillosis (IA) is one of the rarest opportunistic fungal infections and has increased in frequency worldwide in recent years. It is a life-threatening infection associated with high mortality rates. Invasive pulmonary aspergillosis (IPA) is the most severe form of the disease. Extrapulmonary forms can develop as a primary infection or occur as part of a disseminated infection from the lung in severely immunocompromised patients. The major limitation in the management of these infections is the challenge of early diagnosis.
Case presentation
Here we report a case of secondary cutaneous aspergillosis that developed from extensive pulmonary aspergillosis in a 3-year-old female who underwent immunosuppressive therapy for a diagnosed Behçet disease (BD). hyphae were identified on skin biopsies. Cultures grew . The diagnosis of cutaneous aspergillosis enabled us to diagnose IPA, although there was no mycopathological proof of lung infection. The patient was successfully treated with voriconazole (8 mg/kg/day) and surgical debridement of the skin lesion.
Conclusions
Although cutaneous involvement in aspergillosis is extremely uncommon, it may be the presenting feature in some cases, allowing for an accurate and timely diagnosis of deeply infected sites. Accordingly, when evaluating skin lesions in immunocompromised individuals, especially debilitated children with underlying diseases requiring long-term immunosuppressive agents, cutaneous aspergillosis should be vigilantly considered.

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