title: Cutaneous, pulmonary and sinusal aspergillosis in a diabetic patient.
abstract: BACKGROUND
  Cutaneous aspergillosis is rarely reported in diabetic patients.
  
  
  OBJECTIVE
  The objective of our study is to report a case of lethal disseminated aspergillosis revealed by multiples skin necroses, with pulmonary and sinusal involvement in a diabetic patient.
  
  
  METHODS
  A 60-year-old diabetic woman, presented with one month -rapidly -extensive, 1 to 10 cm skin necroses of the trunk, limbs and eyelids. Few days after her admission, she developed dyspnoea. Chest X-ray showed an interstitial and alveolar syndrome with multiple excavated anfractuous-edged-opacities. Facial CT scan showed a right orbital cellulitis with Pansinusitis. The methaminesilver stains on a cutaneous biopsy showed filamentous septate fungal hyphae with branches at right angles. The immunofluorescence with an anti-aspergillus serum was positive. The diagnosis of secondary disseminated aspergillosis to a primary pulmonary focus with cutaneous, sinusal, and upper airway's dissemination was made. The patient died despite an intravenous amphotericin B therapy.
  
  
  CONCLUSIONS
  This report emphasizes the importance of evoking and seeking for a mycosis in every skin necrotic and ulcerative lesions occurring in an immunocompromised patient. The prognosis depends on the diagnosis and treatment institution delay.
authors.affiliation: Department of Dermatology, Charles Nicolle Hospital, Tunis, Tunisia.
authors.forename: Aida
authors.initials: A
authors.lastname: Khaled
authors.forename: Becima
authors.initials: B
authors.lastname: Fazaa
authors.forename: Donia
authors.initials: D
authors.lastname: Ammar
authors.forename: Alya
authors.initials: A
authors.lastname: Bouzgarrou
authors.forename: Samir
authors.initials: S
authors.lastname: Boubaker
authors.forename: Mohamed Ridha
authors.initials: MR
authors.lastname: Kamoun
mesh_terms: D001228:Aspergillosis / Q000175:diagnosis*; D003881:Dermatomycoses / Q000175:diagnosis*; D048909:Diabetes Complications / Q000175:diagnosis* / Q000382:microbiology*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008875:Middle Aged; D055732:Pulmonary Aspergillosis / Q000175:diagnosis*; D012852:Sinusitis / Q000175:diagnosis* / Q000382:microbiology*