To the Editor.—
A patient of ours had disseminated histoplasmosis with cellulitis. Aspiration of the inflamed skin site led to an accurate diagnosis.
Report of a Case.—
A 21-year-old woman who was an immunosuppressed renal transplant recipient was admitted to the University of Virginia Hospital, Charlottesville, because of cellulitis in her right leg. Evaluation of the patient's condition after the development of fever six months earlier had disclosed the presence of granulomas in the bone marrow. However, cultures were negative for organisms and staining was unsuccessful. Two months before admission, the patient had had erythema nodosum on the left leg. One month before admission, the patient had stubbed the third toe on her right foot. Erythema developed and spread to the foot and ankle. Additional details of this patient's history are described elsewhere.1At the time of hospital admission, the patient had a warm, tender, erythematous, indurated rash involving the right foot and ankle (Fig 1). Aspirates of skin did not show any organisms with Gram's stain,