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Case Studies | General Surgery | India | Volume 12 Issue 4, April 2023

Primary Cutaneous Aspergillosis in an Immunocompetent Host Presenting as Ulcero-Proliferative Escharotic Lesion

Rajesha K | Sulay Shah | Devashree Pramodchandra Sane | Samir Deolekar

Abstract: We report a case of a 14-year-old immunocompetent male who presented with an extensive ulcero-proliferative lesion with eschar formation on his left thigh. The lesion had evolved insidiously over the course of 1 year, during which excision of the lesion, extended duration wide spectrum antibiotics and even empirical Anti-tuberculous treatment had been administered to the patient, without much benefit. On referral to our centre, the patient underwent biopsy followed by histological examination and fungal culture of the lesion, which turned out to be positive for Aspergillus and was thus diagnosed to be a Case of Primary Cutaneous Invasive Aspergillosis. On thorough investigation there were No signs of any immunocompromised state. The patient was treated with oral voriconazole, daily wound dressing along with nutritional and functional rehabilitation of the patient. Over the course of 12 weeks, there was sloughing off of the eschar and healthy granulation tissue cover at the site of the lesion. This highlights the clinical challenge in the early diagnosis of this rare cutaneous infection, especially in the setting of an immunocompetent host. Institution of appropriate antifungal therapy and local wound care leads to improved outcomes in these patients without the need for surgical intervention.

Keywords: Aspergillosis, cutaneous, eschar, immunocompetent

Edition: Volume 12 Issue 4, April 2023,

Pages: 890 - 893