Disseminated Fusarium infection in autologous stem cell transplant recipient

Avelino‐Silva, Vivian Iida; Ramos, Jéssica Fernandes; Leal, Fábio E.; Testagrossa, Leonardo; Novis, Yana

doi:10.1016/j.bjid.2014.08.009

Cited by 8 publications

(7 citation statements)

References 17 publications

(22 reference statements)

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“…These infections may manifest as a fever that does not respond to antimicrobial therapy [ 6 ]. Underlying diseases for development of invasive fusariosis are hematologic malignancies, hematopoietic cell transplantation, neutropenia, and impaired cellular immunity [ 5 , 6 , 7 , 8 , 9 ]. Infections may also occur in immunocompetent individuals [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Reduced Multidrug Susceptibility Profile Is a Common Feature of Opportunistic Fusarium Species: Fusarium Multi-Drug Resistant Pattern

Taj-Aldeen

2017

JoF

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The resistance among various opportunistic Fusarium species to different antifungal agents has emerged as a cause of public health problems worldwide. Considering the significance of multi-drug resistant (MDR), this paper emphasizes the problems associated with MDR and the need to understand its clinical significance to combat microbial infections. The search platform PubMed/MEDLINE and a review of 32 cases revealed a common multidrug-resistant profile exists, and clinically relevant members of Fusarium are intrinsically resistant to most currently used antifungals. Dissemination occurs in patients with prolonged neutropenia, immune deficiency, and especially hematological malignancies. Amphotericin B displayed the lowest minimum inhibitory concentrarions (MICs) followed by voriconazole, and posaconazole. Itraconazole and fluconazole showed high MIC values, displaying in vitro resistance. Echinocandins showed the highest MIC values. Seven out of ten (70%) patients with neutropenia died, including those with fungemia that progressed to skin lesions. Clinical Fusarium isolates displayed a common MDR profile and high MIC values for the most available antifungal agents with species- and strain-specific differences in antifungal susceptibility. Species identification of Fusarium infections is important. While the use of natamycin resulted in a favorable outcome in keratitis, AmB and VRC are the most used agents for the treatment of fusariosis in clinical settings.

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Section: Introductionmentioning

confidence: 99%

Reduced Multidrug Susceptibility Profile Is a Common Feature of Opportunistic Fusarium Species: Fusarium Multi-Drug Resistant Pattern

Taj-Aldeen

2017

JoF

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“…Deep and disseminated infections are confined to severely immunocompromised patients. Disseminated infections seem predominantly related to hematological disorders [12], sometimes with a link to a pre-existing nail or cutaneous infection [13,14]. The observed number of fusarioses has been reported to increase over the past several decades: this may be partly due to the growing number of immunocompromised patients and their prolonged average survival time, partly due to prophylactic therapeutic approaches against opportunistic fungal infections which have little impact on Fusarium, and partly to our improved ability to identify the infective agents [14,15].…”

Section: Introductionmentioning

confidence: 99%

Emergence of fusarioses in a university hospital in Turkey during a 20-year period

Cilo

Al‐Hatmi

Seyedmousavi

et al. 2015

Eur J Clin Microbiol Infect Dis

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Fusarium species have started appearing increasingly as the main cause of infections, particularly in immunocompromised patients. In this study, we aimed to present the first epidemiological data from Turkey, analyze fusariosis cases that have been monitored in a university hospital during the past 20 years, identify the responsible Fusarium species, and determine antifungal susceptibilities. A total of 47 cases of fusariosis was included in the study. Fusarium isolates were identified by multilocus sequence typing (MLST). Antifungal susceptibility was tested by the broth microdilution method according to the Clinical and Laboratory Standards Institute (CLSI) methodology. Of the Fusarium infections, 23.4 % were superficial, 44.7 % were locally invasive, and 31.9 % were disseminated. A significant increase was observed over the years. The Fusarium fujikuroi species complex (FFSC) proved to be the most frequent agent group (17 cases; 51.5 %), followed by the Fusarium solani species complex (FSSC) (14 cases; 42.4 %), the Fusarium dimerum species complex (FDSC), and the Fusarium oxysporum species complexes (FOSC) (one case each). Amphotericin B had the highest in vitro activity against all species. Voriconazole and posaconazole showed interspecies variability across and within Fusarium species complexes. In conclusion, our data support the fact that regional differences exist in the distribution of the Fusarium species and that species-specific differences are observed in antifungal susceptibility patterns. The monitoring of local epidemiological data by determining fungal identity and susceptibility are of importance in guiding the clinical followup of patients.Electronic supplementary material The online version of this article

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“…Fusarium spp. lung infection is reported also in bone marrow transplant recipients and liver transplantation [19,20]. This infection has occasionally been described in immunocompetent patients.…”

Section: Discussionmentioning

confidence: 92%

“…lung infections are reported also in transplant patients especially in lung transplant patients seeing as the principle portal of entry of this mold is the airway [24,25]. Disseminated infections are reported also in bone marrow transplant recipients and liver transplantation [19,20]. Ocular infections such as keratitis, endophthalmitis both in immunocompetent and in immunosuppressed patients are also reported.…”

Section: Discussionmentioning

confidence: 99%

Fusariosis in a Patient with Acute Myeloid Leukemia: A Case Report and Review of the Literature

et al. 2016

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Fusarium spp. causes infections mostly in patients with prolonged neutropenia. We describe the case of a disseminated Fusarium solani infection in a patient with acute myeloid leukemia which never reached complete remission during its clinical course. The patient had profound neutropenia and developed skin nodules and pneumonia in spite of posaconazole prophylaxis. F. solani was isolated from blood and skin biopsy, being identified from its morphology and by molecular methods. By broth dilution method, the strain was resistant to azoles, including voriconazole and posaconazole, and to echinocandins. MIC to amphotericin B was 4 mg/L. The patient initially seemed to benefit from therapy with voriconazole and amphotericin B, but, neutropenia perduring, his clinical condition deteriorated with fatal outcome. All efforts should be made to determine the correct diagnosis as soon as possible in a neutropenic patient and to treat this infection in a timely way, assuming pathogen susceptibility while tests of antimicrobial susceptibility are pending. A review of the most recent literature on invasive fungal infections is reported.

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Disseminated Fusarium infection in autologous stem cell transplant recipient

Cited by 8 publications

References 17 publications

Reduced Multidrug Susceptibility Profile Is a Common Feature of Opportunistic Fusarium Species: Fusarium Multi-Drug Resistant Pattern

Reduced Multidrug Susceptibility Profile Is a Common Feature of Opportunistic Fusarium Species: Fusarium Multi-Drug Resistant Pattern

Emergence of fusarioses in a university hospital in Turkey during a 20-year period

Fusariosis in a Patient with Acute Myeloid Leukemia: A Case Report and Review of the Literature

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