Early clinical recognition of disseminated candidiasis by muscle and skin biopsy.

Disseminated candidiasis was clinically diagnosed by muscle and skin biopsies in two patients with hematologic malignancies. One patient with acute promyelocytic leukemia presented with skin lesions as the sole manifestation of disseminated candidiasis. The other patient had leukemic reticuloendotheliosis and developed fever, severe myalgias, and maculopapular rash while receiving corticosteroid therapy; this patient is the first to have antemortem documentation of candida myositis as the initial manifestation of disseminated candidiasis. These two case reports serve to emphasize the importance of careful observation and early biopsy of skin and muscle to establish the diagnosis and permit early institution of therapy.