[An invasive cutaneous aspergillosis during a granulomatosis with polyangiitis]

Rev Med Interne. 2024 Nov;45(11):726-730. doi: 10.1016/j.revmed.2024.09.005. Epub 2024 Oct 10.
[Article in French]

Abstract

Introduction: Aspergillosis is an opportunistic infection that can complicate any situation of immunosuppression. The primary manifestations are pulmonary, and more rarely, in cases of severe immunosuppression, the infection can become invasive with extra-pulmonary involvement.

Observation: We report the case of a 76-year-old female patient, experiencing a relapse of granulomatosis with polyangiitis treated with corticosteroids, rituximab and cyclophosphamide, who presented with diffuse erythematous nodular skin lesions. A biopsy with histological analysis confirmed a diagnosis of invasive cutaneous aspergillosis. Treatment with voriconazole led to a favorable outcome.

Conclusion: The appearance of skin lesions in an inflammatory context in a patient receiving immunosuppressive therapy should prompt a comprehensive microbiological assessment for opportunistic pathogens, as well as a skin biopsy to investigate for invasive cutaneous aspergillosis.

Keywords: ANCA; Aspergillose cutanée invasive; Biopsie cutanée; Immunodeficiency; Immunodépression; Invasive cutaneous aspergillosis; Skin biopsy; Vascularite; Vasculitis.

Publication types

  • Case Reports
  • English Abstract

MeSH terms

  • Aged
  • Aspergillosis* / complications
  • Aspergillosis* / diagnosis
  • Dermatomycoses / diagnosis
  • Dermatomycoses / etiology
  • Dermatomycoses / microbiology
  • Female
  • Granulomatosis with Polyangiitis* / complications
  • Granulomatosis with Polyangiitis* / diagnosis
  • Humans
  • Immunocompromised Host
  • Immunosuppressive Agents / adverse effects
  • Immunosuppressive Agents / therapeutic use
  • Voriconazole / therapeutic use

Substances

  • Immunosuppressive Agents
  • Voriconazole