Nodular cutaneous microsporidiosis in a patient with AIDS and successful treatment with long-term oral clindamycin therapy.

BACKGROUND: In AIDS, nodular skin disease can result from various causes.

OBJECTIVE: To report a new manifestation of microsporidial infection presenting as nodular skin disease with underlying osteomyelitis.

DESIGN: Case report.

SETTING: Tertiary-care military medical center in Washington, D.C.

PATIENT: A 36-year-old woman with late-stage AIDS who presented with disseminated, nodular cutaneous lesions and underlying osteomyelitis.

MEASUREMENTS: Disseminated microsporidial infection with an Encephalitozoon-like species was diagnosed by electron microscopic examination of material obtained from the skin lesions.

INTERVENTION: The patient received long-term oral clindamycin therapy, which cured her disseminated infection.

CONCLUSIONS: Microsporidia can cause disseminated cutaneous infections in AIDS patients. The response of this patient to long-term clindamycin therapy merits further evaluation.