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.