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May 1986, Vol 140, No. 5 >
Article | May 1986

The Value of Skin Biopsies in Febrile, Neutropenic, Immunocompromised Children FREE

Upton Allen, MD; Charles R. Smith, MD; Charles G. Prober, MD
[+] Author Affiliations

Accepted for publication Jan 30, 1986.

Reprint requests to Division of Infectious Diseases, Department of Pediatrics, Stanford University Medical Center, Stanford, CA 94305 (Dr Prober).


Am J Dis Child. 1986;140(5):459-461. doi:10.1001/archpedi.1986.02140190069028.
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• We assessed the value of 41 skin biopsy specimens obtained from 32 immunocompromised patients with fever and neutropenia. Fifty-six percent (23/41) of these biopsy specimens resulted in a specific diagnosis. These diagnoses included infection in 12 cases, graft-vs-host disease in nine, leukemic infiltrate in one, and drug reaction in one. The remaining 18 biopsy specimens showed either nonspecific changes or normal tissue. The infectious agents identified included Aspergillus in nine patients, Candida in three patients, and Staphylococcus aureus in one patient. As a result of the biopsy findings, therapy was altered in 49% (20/41) of the cases. The most frequent therapeutic change was initiation of amphotericin B for a demonstrated fungal infection. We found skin biopsies to be a valuable diagnostic tool in the assessment of the febrile, neutropenic, immunocompromised patient with skin lesions.

(AJDC 1986;140:459-461)

REFERENCES

1 +
Wolfson JS, Sober AJ, Rubin RH:  Dermatologic manifestations of infections in the compromised host . Annu Rev Med 1983;;34:205-217.
2 +
Rubin RH, Young LS (eds): Clinical Approach to Infection in the Immunocompromised Host . New York, Plenum Publishing Corp, 1981;.
3 +
Lennette EH, Balows A, Havsler WJ Jr, et al (eds): Manual of Clinical Microbiology , ed 3. Washington, DC, American Society for Microbiology, 1980;.
4 +
Hughes WT, Haysam T, Bartley DL:  The immune compromised host . Pediatr Clin North Am 1983;;30:103-120.
5 +
Pizzo PA:  Infectious complications in the child with cancer . J Pediatr 1981;;98:341-354.
6 +
Feigin RD, Sheares WT:  Opportunistic infections in children . J Pediatr 1975;;87:507-514.
7 +
Prober CG, Whyte H, Smith CR:  Open lung biopsy in immunocompromised children with pulmonary infiltrates . AJDC 1984;;138:60-63.
8 +
Klotz SA, Drutz DJ, Huppert M, et al:  Pityrosporum folliculitis: Its potential for confusion with skin lesions of systemic candidiasis . Arch Intern Med 1982;;142:2126-2129.
9 +
Koranda FC, Dehmel EM, Guinter K, et al:  Cutaneous complications in immunosuppressed renal homograft recipients . JAMA 1974;;229: 419-424.

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References

1 +
Wolfson JS, Sober AJ, Rubin RH:  Dermatologic manifestations of infections in the compromised host . Annu Rev Med 1983;;34:205-217.
2 +
Rubin RH, Young LS (eds): Clinical Approach to Infection in the Immunocompromised Host . New York, Plenum Publishing Corp, 1981;.
3 +
Lennette EH, Balows A, Havsler WJ Jr, et al (eds): Manual of Clinical Microbiology , ed 3. Washington, DC, American Society for Microbiology, 1980;.
4 +
Hughes WT, Haysam T, Bartley DL:  The immune compromised host . Pediatr Clin North Am 1983;;30:103-120.
5 +
Pizzo PA:  Infectious complications in the child with cancer . J Pediatr 1981;;98:341-354.
6 +
Feigin RD, Sheares WT:  Opportunistic infections in children . J Pediatr 1975;;87:507-514.
7 +
Prober CG, Whyte H, Smith CR:  Open lung biopsy in immunocompromised children with pulmonary infiltrates . AJDC 1984;;138:60-63.
8 +
Klotz SA, Drutz DJ, Huppert M, et al:  Pityrosporum folliculitis: Its potential for confusion with skin lesions of systemic candidiasis . Arch Intern Med 1982;;142:2126-2129.
9 +
Koranda FC, Dehmel EM, Guinter K, et al:  Cutaneous complications in immunosuppressed renal homograft recipients . JAMA 1974;;229: 419-424.

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