Vesicles as initial skin manifestation of disseminated fusariosis after non-myeloablative stem cell transplantation.
A 52-year-old man underwent non-myeloablative stem cell transplantation from his HLA identical sister for the treatment of mantle cell lymphoma. On day 0, he developed a high-grade fever, watery diarrhea and vesicles scattered on the skin. Well experienced dermatologists diagnosed these lesions as VZV reactivation. High dose antiviral agents were ineffective, and Fusarium solani was cultured from his stool and sputum. Systemic fusariosis progressed rapidly and he died of multiorgan failure on day 18. It is sometimes difficult to differentiate between viral and fungal blisters based on macroscopic examinations. We recommend early histopathological examination of the skin, when HSCT recipients develop vesicles.
Hamaki
Tamae
T
Department of Hematology, Toranomon Hospital, 2-2-2 Toranomon, Minato-Ku, Tokyo 105-8470, Japan.
Kami
Masahiro
M
Kishi
Akiko
A
Kusumi
Eiji
E
Kishi
Yukiko
Y
Iwata
Hiroshi
H
Miyakoshi
Shigesaburo
S
Ueyama
Junichi
J
Morinaga
Shinichi
S
Taniguchi
Shuichi
S
Ohara
Kuniaki
K
Muto
Yoshitomo
Y
D001768:Blister; D017809:Fatal Outcome; D016469:Fungemia; D005670:Fusarium / Q000302:isolation & purification*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D020522:Lymphoma, Mantle-Cell / Q000150:complications / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000382:microbiology; D009181:Mycoses / Q000209:etiology* / Q000473:pathology; D012871:Skin Diseases / Q000209:etiology / Q000473:pathology*; D019172:Transplantation Conditioning