PRIMARY CUTANEOUS INFECTION BY ASPERGILLUS-USTUS IN A 62-YEAR-OLD LIVER-TRANSPLANT RECIPIENT

We report the first case of primary cutaneous aspergillosis caused by Aspergillus ustus, a species that seldom infects human beings. The pat ient, a 62-year-old liver transplant recipient with end-stage hepatiti s C-induced cirrhosis, was receiving the experimental immunosuppressiv e drug FK-506. Trauma to the skin of the right arm from tape and from an arm board holding intravenous and intraarterial catheters in place and to the left leg from an occlusive knee brace may have contributed to this unusual mycosis. The patient's cutaneous aspergillosis respond ed to a combination of intravenous amphotericin B and topical terbinaf ine cream. Although the patient died shortly thereafter from hepatic f ailure, there was no evidence of systemic aspergillosis.