The value of skin biopsies in febrile, neutropenic, immunocompromised children
U. Allen, C. R. Smith and C. G. Prober
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.
