Disseminated Skin Lesions After Allogeneic Hematopietic Stem Cell Transplantation

A 40-year-old woman with a history of chronic myeloid leukemia, which progressed to acute myeloid leukemia in August 2015, underwent allogeneic hematopietic stem cell transplantation (in April 2016) from an unrelated donor after conditioning with busulphan and fludarabine. On day 1 after transplantation a fever developed, followed by skin lesions with a diffuse erythematous maculopapular rash on day 5 (Figure 1). Skin biopsy was performed. Blood cultures were negative, but fever persisted despite treatment with broad-spectrum antibiotics (meropenem, vancomycin, polymyxin, voriconazole and Lipossomal amphotericin). Even with intensive treatment, the patient died on day 12, owing to septic shock followed by multiorgan failure.