1887

Abstract

Introduction:

Disseminated fusariosis is a devastating disease in severely immunocompromised patients and is associated with high lethality.

Case presentation:

We describe a patient with severe disseminated fusariosis presenting initially as tonsillitis. was isolated from cultures of the tonsils, skin and blood, while histological evidence for fungal tissue invasion was detected in tissue samples of the tonsils, tongue, oesophagus, lungs, myocardium, intestine, kidney, mediastinal lymphnodes and skin. Susceptibility testing revealed resistance to voriconazole, posaconazole and caspofungin, and susceptibility to amphotericin B. The patient died, despite treatment with amphotericin B, due to multiorgan failure and refractory cardiac arrhythmia.

Conclusion:

Tonsillitis was the primary clinical manifestation of disseminated fatal fusariosis in this immunocompromised patient. It is important to know the spectrum of primary manifestations of less commonly encountered moulds in order to guide clinical decisions and early targeted therapy.

  • This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0/).
Loading

Article metrics loading...

/content/journal/jmmcr/10.1099/jmmcr.0.004028
2014-09-01
2024-11-04
Loading full text...

Full text loading...

/deliver/fulltext/jmmcr/1/3/jmmcr004028.html?itemId=/content/journal/jmmcr/10.1099/jmmcr.0.004028&mimeType=html&fmt=ahah

References

  1. Al‐Abdely H.M. ( 2004). Management of rare fungal infections. Curr Opin Infect Dis 17:527–532 [CrossRef]
    [Google Scholar]
  2. Boutati E.I., Anaissie E.J. ( 1997). Fusarium, a significant emerging pathogen in patients with hematologic malignancy: ten years’ experience at a cancer center and implications for management. Blood 90:999–1008
    [Google Scholar]
  3. Campo M., Lewis R.E., Kontoyiannis D.P. ( 2010). Invasive fusariosis in patients with hematologic malignancies at a cancer center: 1998–2009. J Infect 60:331–337 [CrossRef]
    [Google Scholar]
  4. Diekema D.J., Messer S.A., Hollis R.J., Jones R.N., Pfaller M.A. ( 2003). Activities of caspofungin, itraconazole, posaconazole, ravuconazole, voriconazole, and amphotericin B against 448 recent clinical isolates of filamentous fungi. J Clin Microbiol 41:3623–3626 [CrossRef]
    [Google Scholar]
  5. Hospenthal D. ( 2009). Fusarium species. In Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases, 7th. edn, pp. 3369–3370 Edited by Mandell G., Benent J., Dolin R. Philadelphia: PA: Elsevier;
    [Google Scholar]
  6. Lortholary O., Obenga G., Biswas P., Caillot D., Chachaty E., Bienvenu A.L., Cornet M., Greene J., Herbrecht R. other authors ( 2010). International retrospective analysis of 73 cases of invasive fusariosis treated with voriconazole. Antimicrob Agents Chemother 54:4446–4450 [CrossRef]
    [Google Scholar]
  7. Nucci M., Anaissie E. ( 2002). Cutaneous infection by Fusarium species in healthy and immunocompromised hosts: implications for diagnosis and management. Clin Infect Dis 35:909–920 [CrossRef]
    [Google Scholar]
  8. Nucci M., Anaissie E.J., Queiroz‐Telles F., Martins C.A., Trabasso P., Solza C., Mangini C., Simões B.P., Colombo A.L. other authors( 2003). Outcome predictors of 84 patients with hematologic malignancies and Fusarium infection. Cancer 98:315–319 [CrossRef]
    [Google Scholar]
  9. Paphitou N.I., Ostrosky‐Zeichner L., Paetznick V.L., Rodriguez J.R., Chen E., Rex J.H. ( 2002). In vitro activities of investigational triazoles against Fusarium species: effects of inoculum size and incubation time on broth microdilution susceptibility test results. Antimicrob Agents Chemother 46:3298–3300 [CrossRef]
    [Google Scholar]
  10. Perfect J.R. ( 2005). Treatment of non‐Aspergillus moulds in immunocompromised patients with amphotericin B lipid complex. Clin Infect Dis 40:S401–S408 [CrossRef]
    [Google Scholar]
  11. Raad I.I., Hachem R.Y., Herbrecht R., Graybill J.R., Hare R., Corcoran G., Kontoyiannis D.P. ( 2006). Posaconazole as salvage treatment for invasive fusariosis in patients with underlying hematologic malignancy and other conditions. Clin Infect Dis 42:1398–1403 [CrossRef]
    [Google Scholar]
/content/journal/jmmcr/10.1099/jmmcr.0.004028
Loading
/content/journal/jmmcr/10.1099/jmmcr.0.004028
Loading

Data & Media loading...

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error