Cutaneous aspergillosis in a diabetic patient- A cytological encounter in FNAC

Diabetes mellitus is a public health problem significantly contributing to morbidity and mortality worldwide. The patients are highly prone to opportunistic infections with major systemic as well as cutaneous fungi. The fungal infections frequent in diabetics include Candidiasis as well as cutaneous Aspergillosis. The most commonly involved species include Aspergillus niger, Aspergillus flavus and Aspergillus fumigatus. Presenting here is a case of 60 years male with history of diabetes mellitus type 2 on oral hypoglycaemic agents, presenting in Medicine Out Patient Department with complaints of progressive painless left cystic medial ankle swelling for last 4 months. Patient was then asked to undergo FNAC which revealed pyogenic inflammation with giant cells and fungal hyphae showing acute angled branching. Furthermore, microbiological confirmation was also done and patient was initiated treatment for the same. This case report underlines the importance of FNAC and Cytological study in the accurate and early diagnosis of Cutaneous Aspergillosis even before the more expensive and time-consuming microbiological diagnostic modalities are applied.
 

Keywords: Cutaneous aspergillosis, Diabetics, FNAC