title: Primary cutaneous Candida tropicalis infection in a patient with B-cell lymphoma.
abstract: We report the case of a 61-year-old man with diffuse large B-cell lymphoma who presented with a tender skin lesion on the left side of the flank of 5 weeks' duration after undergoing myeloablative chemotherapy. Prior treatment with intravenous vancomycin showed minimal response. Clinical examination revealed a tender, indurated, erythematous plaque on the left side of the flank. A skin biopsy demonstrated a lymphohistiocytic and neutrophilic infiltrate with deep dermal necrosis and fungal forms in the dermis and subcutis. A tissue culture grew Candida tropicalis; however, blood cultures remained negative for yeast. A diagnosis of primary cutaneous candidiasis was made based on the lack of response to antibiotics, tissue evidence of C tropicalis, and negative blood cultures. Although rare, primary cutaneous candidiasis should be considered in immunocompromised patients presenting with cellulitis or an abscess that is unresponsive to treatment.
authors.forename: Alison M
authors.initials: AM
authors.lastname: Schram
authors.forename: Brian
authors.initials: B
authors.lastname: Kim
authors.forename: Casey
authors.initials: C
authors.lastname: Carlos
authors.forename: Michael T
authors.initials: MT
authors.lastname: Tetzlaff
authors.forename: Mindy
authors.initials: M
authors.lastname: Schuster
authors.affiliation: 2nd Floor, Maloney Bldg, 3400 Spruce St, Philadelphia, PA 19104, USA. misha.rosenbach@uphs.upenn.edu.
authors.forename: Misha
authors.initials: M
authors.lastname: Rosenbach
mesh_terms: D001706:Biopsy; D041022:Candida tropicalis / Q000302:isolation & purification*; D002179:Candidiasis, Cutaneous / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology; D002481:Cellulitis / Q000175:diagnosis; D003937:Diagnosis, Differential; D006801:Humans; D016867:Immunocompromised Host; D016403:Lymphoma, Large B-Cell, Diffuse / Q000473:pathology*; D008297:Male; D008875:Middle Aged