title: Dermal abscesses with Staphylococcus aureus, cytomegalovirus and acid-fast bacilli in a patient with acquired immunodeficiency syndrome (AIDS).
abstract: A 34-year-old man with acquired immunodeficiency syndrome presented with multiple skin lesions clinically suggestive of molluscum contagiosum. Three skin biopsy specimens were obtained which showed dermal abscesses containing multiple gram-positive cocci admixed with granular necrotic dermal material. In 2, there were cytomegalic inclusions present in macrophages and endothelial cells within the granulation tissue; immunohistochemistry was positive for cytomegalovirus (CMV) antigens. One biopsy specimen also contained a few acid-fast bacilli associated with mononuclear inflammatory cells. Cultures from the lesions grew Staphylococcus aureus and the lesions resolved when the patient was administered a course of systemic cephalosporin. Although lesions with multiple infectious agents have been reported in immunosuppressed patients, this is the first case describing the association of 3 organisms in a single skin biopsy specimen.
authors.affiliation: Department of Dermatology, Johns Hopkins Medical Institutions, Baltimore, Maryland.
authors.forename: S
authors.initials: S
authors.lastname: Boudreau
authors.forename: H C
authors.initials: HC
authors.lastname: Hines
authors.forename: A F
authors.initials: AF
authors.lastname: Hood
mesh_terms: D000038:Abscess / Q000209:etiology / Q000382:microbiology*; D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D000328:Adult; D001706:Biopsy; D003587:Cytomegalovirus; D003586:Cytomegalovirus Infections / Q000382:microbiology; D006801:Humans; D008297:Male; D009164:Mycobacterium Infections / Q000382:microbiology; D009162:Mycobacterium avium; D009894:Opportunistic Infections / Q000382:microbiology*; D012871:Skin Diseases / Q000382:microbiology*; D013203:Staphylococcal Infections / Q000382:microbiology; D013211:Staphylococcus aureus