title: Cutaneous Emboli of Invasive Basidiomycosis in a Child With Aplastic Anemia.
abstract: Invasive fungal diseases are a significant cause of mortality among the immunocompromised. This report documents an unusual case of disseminated fungal infection in a child with severe aplastic anemia. The offending fungus, a Basidiomycete, is rarely known to cause human infections. The patient presented acutely with multiple purpuric skin lesions in various parts of the body. The skin biopsy revealed septated fungal hyphae embolized within small dermal blood vessels. Molecular sequencing indicated Earliella scabrosa as the likely organism. The clinical course of the infection was inexorable despite systemic antifungal treatment, resulting in mortality. The literature of human infections due to Basidiomycetes, the usefulness of histopathology in the early diagnosis of the infection, and possible treatment options are discussed.
authors.affiliation: *Yong Loo Lin School of Medicine, National University of Singapore, Singapore; †Division of Paediatric Haematology and Oncology, Khoo Teck Puat-National University Children's Institute, National University Health System, Singapore; ‡Division of Microbiology, Department of Laboratory Medicine, National University Health System, Singapore; and §Department of Pathology, Yong Loo Lin School of Medicine, National University Health System, National University of Singapore, Singapore.
authors.forename: Desmond Shi-Wei
authors.initials: DS
authors.lastname: Lim
authors.forename: Poh-Lin
authors.initials: PL
authors.lastname: Tan
authors.forename: Roland
authors.initials: R
authors.lastname: Jureen
authors.forename: Kong-Bing
authors.initials: KB
authors.lastname: Tan
mesh_terms: D000741:Anemia, Aplastic / Q000150:complications*; D003881:Dermatomycoses / Q000276:immunology* / Q000382:microbiology; D004617:Embolism / Q000382:microbiology; D017809:Fatal Outcome; D006801:Humans; D016867:Immunocompromised Host; D007223:Infant; D008297:Male; D009894:Opportunistic Infections / Q000276:immunology*; D011124:Polyporaceae