PMC4735083_01
(A-C) Nodules and ulcers without pus and marked boundary in the right preotic skin in a 14-year-old Chinese girl associated with Acinetobacter baumannii-related vasculitis (A: At presentation; B: A week later; C: Eleven days later).
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Nodules and ulcers with marked boundary were seen on her right preotic skin (Fig. 1A). Biopsy was sampled on the ulcer for bacteriological and fungal culture and for histopathological examination (Fig. 1B). Ulcers and swelling began to shrink soon after treatment administration and healed within 3 weeks (Fig. 1B and C).
(A) Histology with H&E staining showed giant-cell vasculitis with thromboses, inflammatory infiltrate with lymphocytes, macrophages, and multinucleate giant cells (A, 100x); (B-D) Gomori's methenamine silver nitrate staining showed bacteria within thrombosis (long arrow) and vessel wall in as mycelia, chains and rod about 1 mum width (short arrows, 1000x).
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Histopathology revealed vasculitis with thromboses, granulomatous inflammatory infiltration with lymphocytes, macrophages and a few multinucleate giant cells (Fig. 2A). Grocott's methenamine silver (GMS) staining showed actinomycetes-like mycelia within vessel walls and thrombi (Fig. 2B) while they could be seen as clusters or chains from the epidermis to the subcutaneous tissues (Fig. 2C and D).