FATAL PRIMARY CUTANEOUS ASPERGILLOSIS IN A BONE-MARROW TRANSPLANT RECIPIENT - NOSOCOMIAL ACQUISITION IN A LAMINAR AIR-FLOW ROOM

A case of primary cutaneous aspergillosis occurring in an allogeneic b one marrow transplant recipient in a laminar airflow room is reported. The patient developed grade III graft-versus-host-disease and epiderm olysis. Although the patient had remained in his laminar airflow room from the graft onward, he subsequently developed primary cutaneous asp ergillosis. The aspergillosis became invasive and the patient died. Th e patient was probably contaminated by air containing conidia when he left the sterile room for endoscopy, and the fluidized bed used may ha ve contributed to the local development of the disease. This nosocomia l aspergillosis stresses the necessity of performing invasive procedur es under laminar airflow protection to prevent Aspergillus contaminati on in immunocompromised hosts at risk for aspergillosis.