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.
Candidiasis is the most common fungal infection in immunocompromised patients who are at greater risk for developing disseminated disease. Renal...
