PRIMARY CUTANEOUS ASPERGILLOSIS IN A 13-YEAR-OLD BOY WITH BONE MARROW APLASIA: CASE REPORT

Cutaneous aspergillosisis a rare condition, and while rare in immunocompetent individuals, it predominantly affects immunosuppressed patients, particularly those with hematological-oncological disorders within the pediatric demographic. Herein, we present a 13-year-old boy under follow-up for bone marrow aplasia. The child developed long-lasting fever and papulous and ulcerous indurated skin lesions on his whole body. Blood count showed agranulocytosis with neutrophils count of 10/μl. Thoracic, abdominal and pelvic Computed Tomography (CT) scan has revealed bilateral alveolar syndrome in the lungs. Skin biopsy revealed cutaneous aspergillosis. Despite treatment, the boys condition did not improve, and he passed away 2 weeks following his hospital admission because of septic shock. Cutaneous aspergillosis is due to Aspergillus flavus and A. fumigatus, for primary and secondary (invasive) cases, respectively. The rapid progression of this disease from the initial cutaneous infectious region necessitates prompt medical intervention to avoid increasing the risk of mortality. This condition typically manifests after the fungus is directly inoculated through skin contact with contiguous infected areas or via hematogenous spread from a remote mycotic site to the skin.