Nodular cutaneous microsporidiosis in a patient with AIDS and successful treatment with long-term oral clindamycin therapy.

In AIDS, nodular skin disease can result from various causes. To report a new manifestation of microsporidial infection presenting as nodular skin disease with underlying osteomyelitis. Case report. Tertiary-care military medical center in Washington, D.C. A 36-year-old woman with late-stage AIDS who presented with disseminated, nodular cutaneous lesions and underlying osteomyelitis. Disseminated microsporidial infection with an Encephalitozoon-like species was diagnosed by electron microscopic examination of material obtained from the skin lesions. The patient received long-term oral clindamycin therapy, which cured her disseminated infection. Microsporidia can cause disseminated cutaneous infections in AIDS patients. The response of this patient to long-term clindamycin therapy merits further evaluation.