Cutaneous Fusarium infection in an adolescent with acute leukemia.

Disseminated fusariosis occurred in a pediatric patient with acute lymphocytic leukemia in relapse. The patient had fever and neutropenia, and scattered violaceous papules and vesicles with central erosions that rapidly progressed to generalized, painful, violaceous, papulovesicular lesions with central necrosis. Severe myalgias were associated. The diagnosis was suspected by noting hyphae on a smear of vesicular contents, and confirmed by culture. The clinical course was rapidly fatal despite early institution of amphotericin B therapy. Disseminated Fusarium infection should be suspected in immunocompromised patients with fever and neutropenia who have generalized, eroded, violaceous papules, vesicles, and pustules, particularly with associated myalgias.