Official reprint from UpToDate®
www.uptodate.com ©2018 UpToDate, Inc. and/or its affiliates. All Rights Reserved.

Fever and rash in immunocompromised patients without HIV infection

Fred A Lopez, MD
Charles V Sanders, MD
Section Editor
Carol A Kauffman, MD
Deputy Editor
Anna R Thorner, MD


At least 20 percent of immunocompromised hosts will develop skin lesions, frequently accompanied by fever [1,2]. Immunocompromising diseases can cause multiple defects in host defenses, which, in turn, lead to heightened susceptibility to various types of infections. Knowledge of these immune defects and the specific associated infections can assist the clinician in the initial evaluation and management of the immunocompromised patient with skin lesions. These lesions sometimes reflect disseminated infection; evaluation of the skin may provide the most rapid diagnosis and thus may be lifesaving.

Some of the common infectious agents and dermatologic manifestations observed in selected immunodeficient states will be reviewed here. Fever and rash in immunocompetent patients and HIV-infected individuals are discussed separately. (See "Fever and rash in the immunocompetent patient" and "Fever and rash in HIV-infected patients".)


Underlying diseases that affect various host defenses may predispose the patient to different types of infections. This section provides a brief overview of the different categories of immunocompromise and the types of pathogens that are most likely to affect patients in each category. It is not intended to provide comprehensive details on the immunology of each condition or an exhaustive list of infections that each type of host might experience. Following this overview of immunocompromising conditions, pathogens that most frequently cause fever and rash in immunocompromised hosts will be discussed.

Neutropenia or neutrophil dysfunction — Patients with prolonged or profound neutropenia or neutrophil dysfunction are at increased risk for developing infections with a variety of organisms, including gram-positive, gram-negative, and anaerobic bacteria, as well as fungi.

The most common cause of neutropenia is the administration of chemotherapeutic agents to patients with cancer. However, a number of other conditions also lead to neutrophil depletion or dysfunction, including acute myeloproliferative disorders, myelodysplastic syndromes, aplastic anemia, congenital or cyclic neutropenia, overwhelming sepsis, Felty's syndrome, or receipt of certain other drugs including azathioprine, mycophenolate mofetil, and ganciclovir.

To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:

Subscribers log in here

Literature review current through: Dec 2017. | This topic last updated: Oct 26, 2017.
The content on the UpToDate website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditions. The use of this website is governed by the UpToDate Terms of Use ©2018 UpToDate, Inc.
  1. Donowitz GR. Fever in the compromised host. Infect Dis Clin North Am 1996; 10:129.
  2. Wolfson JS, Sober AJ, Rubin RH. Dermatologic manifestations of infections in immunocompromised patients. Medicine (Baltimore) 1985; 64:115.
  3. Hermaszewski RA, Webster AD. Primary hypogammaglobulinaemia: a survey of clinical manifestations and complications. Q J Med 1993; 86:31.
  4. Wara DW. Host defense against Streptococcus pneumoniae: the role of the spleen. Rev Infect Dis 1981; 3:299.
  5. Cunha BA. Infections and asplenia. Infect Dis Pract 1997; 21:48.
  6. Wallis RS, Broder MS, Wong JY, et al. Granulomatous infectious diseases associated with tumor necrosis factor antagonists. Clin Infect Dis 2004; 38:1261.
  7. Crum NF, Lederman ER, Wallace MR. Infections associated with tumor necrosis factor-alpha antagonists. Medicine (Baltimore) 2005; 84:291.
  8. Ali T, Chakraburtty A, Mahmood S, Bronze MS. Risk of nocardial infections with anti-tumor necrosis factor therapy. Am J Med Sci 2013; 346:166.
  9. Wendling D, Murad M, Mathieu S, et al. Systemic nocardiosis in a case of rheumatoid arthritis treated with tumor necrosis factor blockers. J Rheumatol 2008; 35:539.
  10. Mohan AK, Coté TR, Block JA, et al. Tuberculosis following the use of etanercept, a tumor necrosis factor inhibitor. Clin Infect Dis 2004; 39:295.
  11. Centers for Disease Control and Prevention (CDC). Tuberculosis associated with blocking agents against tumor necrosis factor-alpha--California, 2002-2003. MMWR Morb Mortal Wkly Rep 2004; 53:683.
  12. Winthrop KL, Chang E, Yamashita S, et al. Nontuberculous mycobacteria infections and anti-tumor necrosis factor-alpha therapy. Emerg Infect Dis 2009; 15:1556.
  13. Winthrop KL, Yamashita S, Beekmann SE, et al. Mycobacterial and other serious infections in patients receiving anti-tumor necrosis factor and other newly approved biologic therapies: case finding through the Emerging Infections Network. Clin Infect Dis 2008; 46:1738.
  14. True DG, Penmetcha M, Peckham SJ. Disseminated cryptococcal infection in rheumatoid arthritis treated with methotrexate and infliximab. J Rheumatol 2002; 29:1561.
  15. Arnaud L, Sene D, Costedoat-Chalumeau N, et al. Disseminated cryptococcal infection and anti-tumor necrosis factor-alpha treatment for refractory sarcoidosis: an expected association? J Rheumatol 2009; 36:462.
  16. Mehta BM, Hashkes PJ, Avery R, Deal CL. A 21-year-old man with Still's disease with fever, rash, and pancytopenia. Arthritis Care Res (Hoboken) 2010; 62:575.
  17. Lee JH, Slifman NR, Gershon SK, et al. Life-threatening histoplasmosis complicating immunotherapy with tumor necrosis factor alpha antagonists infliximab and etanercept. Arthritis Rheum 2002; 46:2565.
  18. Bergstrom L, Yocum DE, Ampel NM, et al. Increased risk of coccidioidomycosis in patients treated with tumor necrosis factor alpha antagonists. Arthritis Rheum 2004; 50:1959.
  19. Hernández-Torres A, García-Vázquez E, Frías-Iniesta J, et al. Cutaneous leishmaniasis in a patient receiving infliximab. Scand J Infect Dis 2013; 45:567.
  20. Zanger P, Kötter I, Kremsner PG, Gabrysch S. Tumor necrosis factor alpha antagonist drugs and leishmaniasis in Europe. Clin Microbiol Infect 2012; 18:670.
  21. Salmon-Ceron D, Tubach F, Lortholary O, et al. Drug-specific risk of non-tuberculosis opportunistic infections in patients receiving anti-TNF therapy reported to the 3-year prospective French RATIO registry. Ann Rheum Dis 2011; 70:616.
  22. Joshi N, Caputo GM, Weitekamp MR, Karchmer AW. Infections in patients with diabetes mellitus. N Engl J Med 1999; 341:1906.
  23. Roden MM, Zaoutis TE, Buchanan WL, et al. Epidemiology and outcome of zygomycosis: a review of 929 reported cases. Clin Infect Dis 2005; 41:634.
  24. Adam RD, Hunter G, DiTomasso J, Comerci G Jr. Mucormycosis: emerging prominence of cutaneous infections. Clin Infect Dis 1994; 19:67.
  25. Klein NC, Cunha BA. Infections in systemic lupus erythematosus. Infectious Diseases in Clinical Practice 1999; 8:225.
  26. Cuchacovich R, Gedalia A. Pathophysiology and clinical spectrum of infections in systemic lupus erythematosus. Rheum Dis Clin North Am 2009; 35:75.
  27. Nived O, Sturfelt G, Wollheim F. Systemic lupus erythematosus and infection: a controlled and prospective study including an epidemiological group. Q J Med 1985; 55:271.
  28. Petri M. Infection in systemic lupus erythematosus. Rheum Dis Clin North Am 1998; 24:423.
  29. Mendez EA, Espinoza LM, Harris M, et al. Systemic lupus erythematosus complicated by necrotizing fasciitis. Lupus 1999; 8:157.
  30. Parada JP, Maslow JN. Clinical syndromes associated with adult pneumococcal cellulitis. Scand J Infect Dis 2000; 32:133.
  31. Page KR, Karakousis PC, Maslow JN. Postoperative pneumococcal cellulitis in systemic lupus erythematosus. Scand J Infect Dis 2003; 35:141.
  32. Hill MD, Karsh J. Invasive soft tissue infections with Streptococcus pneumoniae in patients with systemic lupus erythematosus: case report and review of the literature. Arthritis Rheum 1997; 40:1716.
  33. Stevens DL, Bisno AL, Chambers HF, et al. Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the infectious diseases society of America. Clin Infect Dis 2014; 59:147.
  34. Richard P, Amador Del Valle G, Moreau P, et al. Viridans streptococcal bacteraemia in patients with neutropenia. Lancet 1995; 345:1607.
  35. Engelhard D, Elishoov H, Or R, et al. Cytosine arabinoside as a major risk factor for Streptococcus viridans septicemia following bone marrow transplantation: a 5-year prospective study. Bone Marrow Transplant 1995; 16:565.
  36. Ahmed R, Hassall T, Morland B, Gray J. Viridans streptococcus bacteremia in children on chemotherapy for cancer: an underestimated problem. Pediatr Hematol Oncol 2003; 20:439.
  37. Marron A, Carratalà J, González-Barca E, et al. Serious complications of bacteremia caused by Viridans streptococci in neutropenic patients with cancer. Clin Infect Dis 2000; 31:1126.
  38. Bodey GP. Dermatologic manifestations of infections in neutropenic patients. Infect Dis Clin North Am 1994; 8:655.
  39. Villablanca JG, Steiner M, Kersey J, et al. The clinical spectrum of infections with viridans streptococci in bone marrow transplant patients. Bone Marrow Transplant 1990; 5:387.
  40. Taylor SN, Sanders CV. Unusual manifestations of invasive pneumococcal infection. Am J Med 1999; 107:12S.
  41. Patel M, Ahrens JC, Moyer DV, DiNubile MJ. Pneumococcal soft-tissue infections: a problem deserving more recognition. Clin Infect Dis 1994; 19:149.
  42. Farley MM. Group B streptococcal disease in nonpregnant adults. Clin Infect Dis 2001; 33:556.
  43. Skoff TH, Farley MM, Petit S, et al. Increasing burden of invasive group B streptococcal disease in nonpregnant adults, 1990-2007. Clin Infect Dis 2009; 49:85.
  44. Bodey GP, Rodriguez S, Fainstein V, Elting LS. Clostridial bacteremia in cancer patients. A 12-year experience. Cancer 1991; 67:1928.
  45. Pelletier JP, Plumbley JA, Rouse EA, Cina SJ. The role of Clostridium septicum in paraneoplastic sepsis. Arch Pathol Lab Med 2000; 124:353.
  46. Chatzinikolaou I, Abi-Said D, Bodey GP, et al. Recent experience with Pseudomonas aeruginosa bacteremia in patients with cancer: Retrospective analysis of 245 episodes. Arch Intern Med 2000; 160:501.
  47. Ramphal R. Changes in the etiology of bacteremia in febrile neutropenic patients and the susceptibilities of the currently isolated pathogens. Clin Infect Dis 2004; 39 Suppl 1:S25.
  48. Bodey GP, Bolivar R, Fainstein V, Jadeja L. Infections caused by Pseudomonas aeruginosa. Rev Infect Dis 1983; 5:279.
  49. Bagel J, Grossman ME. Subcutaneous nodules in Pseudomonas sepsis. Am J Med 1986; 80:528.
  50. Agger WA, Mardan A. Pseudomonas aeruginosa infections of intact skin. Clin Infect Dis 1995; 20:302.
  51. el Baze P, Thyss A, Vinti H, et al. A study of nineteen immunocompromised patients with extensive skin lesions caused by Pseudomonas aeruginosa with and without bacteremia. Acta Derm Venereol 1991; 71:411.
  52. Fine JD, Miller JA, Harrist TJ, Haynes HA. Cutaneous lesions in disseminated candidiasis mimicking ecthyma gangrenosum. Am J Med 1981; 70:1133.
  53. Huminer D, Siegman-Igra Y, Morduchowicz G, Pitlik SD. Ecthyma gangrenosum without bacteremia. Report of six cases and review of the literature. Arch Intern Med 1987; 147:299.
  54. Reich HL, Williams Fadeyi D, Naik NS, et al. Nonpseudomonal ecthyma gangrenosum. J Am Acad Dermatol 2004; 50:S114.
  55. Son YM, Na SY, Lee HY, et al. Ecthyma Gangrenosum: A Rare Cutaneous Manifestation Caused by Stenotrophomonas maltophilia in a Leukemic Patient. Ann Dermatol 2009; 21:389.
  56. Kimyai-Asadi A, Tausk FA, Nousari HC. Ecthyma secondary to herpes simplex virus infection. Clin Infect Dis 1999; 29:454.
  57. Fergie JE, Patrick CC, Lott L. Pseudomonas aeruginosa cellulitis and ecthyma gangrenosum in immunocompromised children. Pediatr Infect Dis J 1991; 10:496.
  58. Song WK, Kim YC, Park HJ, Cinn YW. Ecthyma gangrenosum without bacteraemia in a leukaemic patient. Clin Exp Dermatol 2001; 26:395.
  59. Vartivarian SE, Papadakis KA, Palacios JA, et al. Mucocutaneous and soft tissue infections caused by Xanthomonas maltophilia. A new spectrum. Ann Intern Med 1994; 121:969.
  60. Elting LS, Bodey GP. Septicemia due to Xanthomonas species and non-aeruginosa Pseudomonas species: increasing incidence of catheter-related infections. Medicine (Baltimore) 1990; 69:296.
  61. Moser C, Jønsson V, Thomsen K, et al. Subcutaneous lesions and bacteraemia due to Stenotrophomonas maltophilia in three leukaemic patients with neutropenia. Br J Dermatol 1997; 136:949.
  62. Micozzi A, Venditti M, Monaco M, et al. Bacteremia due to Stenotrophomonas maltophilia in patients with hematologic malignancies. Clin Infect Dis 2000; 31:705.
  63. Bin Abdulhak AA, Zimmerman V, Al Beirouti BT, et al. Stenotrophomonas maltophilia infections of intact skin: a systematic review of the literature. Diagn Microbiol Infect Dis 2009; 63:330.
  64. Shapiro RL, Altekruse S, Hutwagner L, et al. The role of Gulf Coast oysters harvested in warmer months in Vibrio vulnificus infections in the United States, 1988-1996. Vibrio Working Group. J Infect Dis 1998; 178:752.
  65. Gulig PA, Bourdage KL, Starks AM. Molecular Pathogenesis of Vibrio vulnificus. J Microbiol 2005; 43 Spec No:118.
  66. Centers for Disease Control and Prevention (CDC). Vibrio illnesses after Hurricane Katrina--multiple states, August-September 2005. MMWR Morb Mortal Wkly Rep 2005; 54:928.
  67. Klontz KC, Lieb S, Schreiber M, et al. Syndromes of Vibrio vulnificus infections. Clinical and epidemiologic features in Florida cases, 1981-1987. Ann Intern Med 1988; 109:318.
  68. Lin CS, Cheng SH. Aeromonas hydrophila sepsis presenting as meningitis and necrotizing fasciitis in a man with alcoholic liver cirrhosis. J Formos Med Assoc 1998; 97:498.
  69. Janda JM, Abbott SL. Evolving concepts regarding the genus Aeromonas: an expanding Panorama of species, disease presentations, and unanswered questions. Clin Infect Dis 1998; 27:332.
  70. Lau SM, Peng MY, Chang FY. Outcomes of Aeromonas bacteremia in patients with different types of underlying disease. J Microbiol Immunol Infect 2000; 33:241.
  71. Kalb RE, Kaplan MH, Grossman ME. Cutaneous nocardiosis. Case reports and review. J Am Acad Dermatol 1985; 13:125.
  72. Georghiou PR, Blacklock ZM. Infection with Nocardia species in Queensland. A review of 102 clinical isolates. Med J Aust 1992; 156:692.
  73. Tappeiner G, Wolff K. Tuberculosis and Other Mycobacterial Infections. In: Dermatology in General Medicine, 5th ed, Fitzpatrick TB, Eisen AZ, Wolff K, et al (Eds), McGraw Hill, New York 1999. p.2274.
  74. Barbagallo J, Tager P, Ingleton R, et al. Cutaneous tuberculosis: diagnosis and treatment. Am J Clin Dermatol 2002; 3:319.
  75. Asnis DS, Bresciani AR. Cutaneous tuberculosis: a rare presentation of malignancy. Clin Infect Dis 1992; 15:158.
  76. Johnson RA, Avram M, Chan E. Skin infections in the immunocompromised host-NonHIV. In: The Skin and Infection: A Color Atlas and Text, Sanders CV, Nesbitt LT Jr (Eds), Williams and Wilkins, Baltimore 1995. p.254.
  77. Street ML, Umbert-Millet IJ, Roberts GD, Su WP. Nontuberculous mycobacterial infections of the skin. Report of fourteen cases and review of the literature. J Am Acad Dermatol 1991; 24:208.
  78. Stengem J, Grande KK, Hsu S. Localized primary cutaneous Mycobacterium kansasii infection in an immunocompromised patient. J Am Acad Dermatol 1999; 41:854.
  79. Kristjansson M, Bieluch VM, Byeff PD. Mycobacterium haemophilum infection in immunocompromised patients: case report and review of the literature. Rev Infect Dis 1991; 13:906.
  80. Shah MK, Sebti A, Kiehn TE, et al. Mycobacterium haemophilum in immunocompromised patients. Clin Infect Dis 2001; 33:330.
  81. Straus WL, Ostroff SM, Jernigan DB, et al. Clinical and epidemiologic characteristics of Mycobacterium haemophilum, an emerging pathogen in immunocompromised patients. Ann Intern Med 1994; 120:118.
  82. Swetter SM, Kindel SE, Smoller BR. Cutaneous nodules of Mycobacterium chelonae in an immunosuppressed patient with preexisting pulmonary colonization. J Am Acad Dermatol 1993; 28:352.
  83. Patel R, Roberts GD, Keating MR, Paya CV. Infections due to nontuberculous mycobacteria in kidney, heart, and liver transplant recipients. Clin Infect Dis 1994; 19:263.
  84. Hoffman PC, Fraser DW, Robicsek F, et al. Two outbreaks of sternal wound infection due to organisms of the Mycobacterium fortuitum complex. J Infect Dis 1981; 143:533.
  85. Horsburgh CR Jr, Mason UG 3rd, Farhi DC, Iseman MD. Disseminated infection with Mycobacterium avium-intracellulare. A report of 13 cases and a review of the literature. Medicine (Baltimore) 1985; 64:36.
  86. Swerdloff JN, Filler SG, Edwards JE Jr. Severe candidal infections in neutropenic patients. Clin Infect Dis 1993; 17 Suppl 2:S457.
  87. Bodey GP, Luna M. Skin lesions associated with disseminated candidiasis. JAMA 1974; 229:1466.
  88. Walsh TJ, Newman KR, Moody M, et al. Trichosporonosis in patients with neoplastic disease. Medicine (Baltimore) 1986; 65:268.
  89. Girmenia C, Pagano L, Martino B, et al. Invasive infections caused by Trichosporon species and Geotrichum capitatum in patients with hematological malignancies: a retrospective multicenter study from Italy and review of the literature. J Clin Microbiol 2005; 43:1818.
  90. Fournier S, Pavageau W, Feuillhade M, et al. Use of voriconazole to successfully treat disseminated Trichosporon asahii infection in a patient with acute myeloid leukaemia. Eur J Clin Microbiol Infect Dis 2002; 21:892.
  91. Pema K, Diaz J, Guerra LG, et al. Disseminated cutaneous cryptococcosis. Comparison of clinical manifestations in the pre-AIDS and AIDS eras. Arch Intern Med 1994; 154:1032.
  92. Neuville S, Dromer F, Morin O, et al. Primary cutaneous cryptococcosis: a distinct clinical entity. Clin Infect Dis 2003; 36:337.
  93. Anderson DJ, Schmidt C, Goodman J, Pomeroy C. Cryptococcal disease presenting as cellulitis. Clin Infect Dis 1992; 14:666.
  94. Pagano L, Fianchi L, Caramatti C, et al. Cryptococcosis in patients with hematologic malignancies. A report from GIMEMA-infection. Haematologica 2004; 89:852.
  95. Abuav R, McGirt LY, Kazin RA. Cryptococcal panniculitis in an immunocompromised patient: a case report and review of the literature. Cutis 2010; 85:303.
  96. Sun HY, Alexander BD, Lortholary O, et al. Cutaneous cryptococcosis in solid organ transplant recipients. Med Mycol 2010; 48:785.
  97. Baer S, Baddley JW, Gnann JW, Pappas PG. Cryptococcal disease presenting as necrotizing cellulitis in transplant recipients. Transpl Infect Dis 2009; 11:353.
  98. Galimberti R, Kowalczuk A, Hidalgo Parra I, et al. Cutaneous aspergillosis: a report of six cases. Br J Dermatol 1998; 139:522.
  99. Allo MD, Miller J, Townsend T, Tan C. Primary cutaneous aspergillosis associated with Hickman intravenous catheters. N Engl J Med 1987; 317:1105.
  100. Walsh TJ. Primary cutaneous aspergillosis--an emerging infection among immunocompromised patients. Clin Infect Dis 1998; 27:453.
  101. van Burik JA, Colven R, Spach DH. Cutaneous aspergillosis. J Clin Microbiol 1998; 36:3115.
  102. Isaac M. Cutaneous aspergillosis. Dermatol Clin 1996; 14:137.
  103. Petrikkos G, Skiada A, Lortholary O, et al. Epidemiology and clinical manifestations of mucormycosis. Clin Infect Dis 2012; 54 Suppl 1:S23.
  104. Ribes JA, Vanover-Sams CL, Baker DJ. Zygomycetes in human disease. Clin Microbiol Rev 2000; 13:236.
  105. Wirth F, Perry R, Eskenazi A, et al. Cutaneous mucormycosis with subsequent visceral dissemination in a child with neutropenia: a case report and review of the pediatric literature. J Am Acad Dermatol 1997; 36:336.
  106. Nucci M, Anaissie E. Cutaneous infection by Fusarium species in healthy and immunocompromised hosts: implications for diagnosis and management. Clin Infect Dis 2002; 35:909.
  107. Boutati EI, Anaissie EJ. Fusarium, a significant emerging pathogen in patients with hematologic malignancy: ten years' experience at a cancer center and implications for management. Blood 1997; 90:999.
  108. Bodey GP, Boktour M, Mays S, et al. Skin lesions associated with Fusarium infection. J Am Acad Dermatol 2002; 47:659.
  109. Fishman JA. Overview: fungal infections in the transplant patient. Transpl Infect Dis 2002; 4 Suppl 3:3.
  110. Campagnaro EL, Woodside KJ, Early MG, et al. Disseminated Pseudallescheria boydii (Scedosporium apiospermum) infection in a renal transplant patient. Transpl Infect Dis 2002; 4:207.
  111. Nucci M, Anaissie E. Fusarium infections in immunocompromised patients. Clin Microbiol Rev 2007; 20:695.
  112. Body BA. Cutaneous manifestations of systemic mycoses. Dermatol Clin 1996; 14:125.
  113. Pappas PG, Threlkeld MG, Bedsole GD, et al. Blastomycosis in immunocompromised patients. Medicine (Baltimore) 1993; 72:311.
  114. Bradsher RW. Histoplasmosis and blastomycosis. Clin Infect Dis 1996; 22 Suppl 2:S102.
  115. Hobbs ER. Coccidioidomycosis. Dermatol Clin 1989; 7:227.
  116. Quimby SR, Connolly SM, Winkelmann RK, Smilack JD. Clinicopathologic spectrum of specific cutaneous lesions of disseminated coccidioidomycosis. J Am Acad Dermatol 1992; 26:79.
  117. Chang P, Rodas C. Skin lesions in histoplasmosis. Clin Dermatol 2012; 30:592.
  118. Kauffman CA, Israel KS, Smith JW, et al. Histoplasmosis in immunosuppressed patients. Am J Med 1978; 64:923.
  119. Studdard J, Sneed WF, Taylor MR Jr, Campbell GD. Cutaneous histoplasmosis. Am Rev Respir Dis 1976; 113:689.
  120. Freifeld AG, Wheat LJ, Kaul DR. Histoplasmosis in solid organ transplant recipients: early diagnosis and treatment. Curr Opin Organ Transplant 2009; 14:601.
  121. Vinicki JP, Tiraboschi IN, Fernandez D, et al. Necrotizing vasculitis secondary to disseminated histoplasmosis simulating pyoderma gangrenosum. Rheumatology (Oxford) 2013; 52:2304.
  122. Dufresne SF, LeBlanc RE, Zhang SX, et al. Histoplasmosis and subcutaneous nodules in a kidney transplant recipient: erythema nodosum versus fungal panniculitis. Transpl Infect Dis 2013; 15:E58.
  123. Romano C, Castelli A, Laurini L, Massai L. Case report. Primary cutaneous histoplasmosis in an immunosuppressed patient. Mycoses 2000; 43:151.
  124. Ramos-E-Silva M, Saraiva Ldo E. Paracoccidioidomycosis. Dermatol Clin 2008; 26:257.
  125. Shikanai-Yasuda MA, Telles Filho Fde Q, Mendes RP, et al. [Guidelines in paracoccidioidomycosis]. Rev Soc Bras Med Trop 2006; 39:297.
  126. Pagnoux C, Seror R, Henegar C, et al. Clinical features and outcomes in 348 patients with polyarteritis nodosa: a systematic retrospective study of patients diagnosed between 1963 and 2005 and entered into the French Vasculitis Study Group Database. Arthritis Rheum 2010; 62:616.
  127. Gibson LE, Su WP. Cutaneous vasculitis. Rheum Dis Clin North Am 1995; 21:1097.
Topic Outline