Disseminated fusariosis in immunocompromised patients.

Immunocompromised patients are at high risk of developing serious disseminated infections by opportunistic fungi (Aspergillus, Candida, and Fusarium spp), which frequently present as cutaneous lesions, sometimes as a first sign. Prolonged and deep neutropenia, immunodepressive treatments (systemic steroids and chemotherapy) and severe T-cell immunodeficiency are the most important risk factors. We report 2 patients with acute lymphoblastic leukemia, who developed multiple tender erythematous skin lesions on their legs and arms during chemotherapy treatment. Skin biopsies for histology and culture studies established the diagnosis of Fusarium infection. They received treatment with systemic antifungal and granulocyte colony-stimulting factor. The infection responded after recovering from neutropenia. Early diagnosis and treatment is very important to improve the prognosis, because these infections in immunodepressed hosts have a high mortality rate.

Adenopatía axilar de primario oculto. Manejo clínico / Axillary lymph node metastases from an unknown primary source. Clinical management

Presentamos un caso reciente de adenopatía axilar de primario desconocido. Describimos las maniobras clínicas y los estudios complementarios que nos llevaron a sospechar una neoplasia mamaria homolateral oculta. Asimismo, describimos las opciones terapéuticas disponibles actualmente para tratar estos casos. Finalmente, presentamos los principales modelos etiopatogénicos propuestos para explicar estas formas de presentación

A recently diagnosed case of axillary lymph node metastases from an unknown primary source is presented. The diagnostic procedures that led us to a diagnosis of «occult» ipsilateral breast cancer and the therapeutic options currently available to treat these cases are described. Finally, some widely accepted hypotheses to explain these unusual breast cancer presentations are discussed