Hyperleukocytosis with pertussis.

A 9-month-old nonimmunized white female patient presented with a paroxysmal cough and a white blood cell count of 114,000/mm3. A nasopharyngeal culture was positive for Bordetella pertussis. Hyperleukocytosis is a rare complication of pertussis and is attributed to lymphocytosis-promoting factor. Hyperleukocytosis with pulmonary leukostasis can result in significant hypoxemia, although it did not occur in the case presented.

Primary cutaneous aspergillosis in a leukemic child.

Primary cutaneous aspergillosis is rare. In this report we describe a primary skin infection by Aspergillus flavus in a child with leukemia. The lesions were characterized by erythematous macules and papules associated with pain and itching, followed by a rapid progression to ulcers and central black eschars with a raised erythematous border. A favorable response to topical nystatin therapy was observed. The multiple cutaneous lesions seen in our patient were most likely due to primary inoculation near the site of intravenous infusion with subsequent local lymphatic spread.