Case Report: Primary Cutaneous Aspergillosis in a Neutropenic Child with Pulmonary Dissemination: A case report

<ns3:p> Introduction Invasive aspergillosis is a severe infection that usually affects immunocompromised patients. Primary cutaneous involvement is a rare presentation and presents a challenge for early diagnosis. We report a case of primary cutaneous aspergillosis (PCA) in an immunocompromised patient with no evident prior skin trauma and with pulmonary dissemination. Case report We report the case of primary cutaneous aspergillosis involving the left ankle in a 5-year-old girl with no history of preceding trauma. The patient was undergoing chemotherapy for lymphoblastic leukemia. <ns3:italic>Aspergillus</ns3:italic> hyphae were identified on skin biopsy. Cultures grew <ns3:italic>Aspergillus flavus.</ns3:italic> The diagnosis of cutaneous aspergillosis enabled the diagnosis of probable pulmonary aspergillosis, although there was no mycopathological proof of lung infection. The patient was treated with initial Amphotericin B followed by Voriconazole with complete skin and respiratory response. Conclusion This case underscores the critical need to consider cutaneous aspergillosis in immunocompromised patients with necrotic skin lesions— even in the absence of obvious trauma—as prompt diagnosis and treatment are vital to prevent dissemination and and improve outcomes. </ns3:p>