As disseminated infections with filamentous fungi or mycobacteria are difficult to diagnose in a timely fashion, biopsies and cultures of suspicious skin lesions are often helpful. Pseudomonas, Candida spp., and Fusarium are particularly likely to be associated with skin lesions. Lesions of ecthyma gangrenosum most often reflect disseminated infection with Pseudomonas. Disseminated candidiasis can present with nodular or papular scat tered lesions. Dark necrotic-appearing lesions can reflect either bacterial or fungal infection. Peripheral embolic phenomena reflecting endovascular infection may occur in the absence of positive blood cultures.
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