Dermal abscesses with Staphylococcus aureus, cytomegalovirus and acid‐fast bacilli in a patient with acquired immunodeficiency syndrome (AIDS)

A 34‐year‐old man with acquired immunodeficiency syndrome presented with multiple skin lesions clinically suggestive of molluscum contagiosum. Three skin biopsy specimens were obtained which showed dermal abscesses containing multiple gram‐positive cocci admixed with granular necrotic dermal material. In 2, there were cytomegalic inclusions present in macro‐phages and endothelial cells within the granulation tissue; immunohistochemistry was positive for cytomegalovirus (CMV) antigens. One biopsy specimen also contained a few acid‐fast bacilli associated with mononuclear inflammatory cells. Cultures from the lesions grew Staphylococcus aureus and the lesions resolved when the patient was administered a course of systemic cephalosporin. Although lesions with multiple infectious agents have been reported in immunosuppressed patients, this is the first case describing the association of 3 organisms in a single skin biopsy specimen.