Cutaneous Candida tropicalis in a Pediatric Acute Lymphoblastic Leukemia Patient: Purpura Without Vascular Invasion

We report a 13-year-old female with B-cell acute lymphoblastic leukemia and neutropenia who developed a purpuric eruption 1 week after resolution of Candida tropicalis fungemia. Repeat blood cultures were negative, yet skin biopsy and tissue culture showed numerous dermal C. tropicalis without vascular invasion. Purpura in neutropenic patients often signals angioinvasive infection, yet studies show Candida-associated purpura may result from vascular injury rather than true vessel invasion. Recognizing this pattern bears clinical significance as non angioinvasive Candida carries a better prognosis and may prevent unnecessary antifungal escalation or surgical intervention.