Primary Disseminated Pulmonary Aspergillosis With Metastatic Skin Nodules

The diagnosis of extensive pulmonary aspergillosis with multiple metastatic skin lesions was established in a 3 1/2-year-old female child who had had no prior debilitating disease. The hyphae ofAspergilluswere identified in both the skin and lung biopsies. In addition,A fumigatuswas cultured from the lung biopsy material. A reversal and clearing of the disease process occurred in both the lungs and skin after a few weeks of aerosol nystatin therapy. Measurable levels of nystatin were found in the blood after inhalation therapy, but no nystatin could be measured after oral administration alone.