Disseminated fusariosis with cutaneous involvement in hematologic malignancies: report of six cases with high mortality rate

Abstract

Fusariosis is due to inhalation or direct contact with conidia. Clinical presentation depends on host's immunity and can be localized, focally invasive or disseminated. Given the severity of this infection and the possibility for the dermatologist to make an early diagnosis, we report six cases of patients with hematologic malignancies, who developed febrile neutropenia an skin lesions suggestive of cutaneous fusariosis. All patients had skin cultures showing growth of Fusarium solani complex, and they received amphotericin B and voriconazole. As this infection can quickly lead to death, dermatologists play a crucial role in diagnosing this disease.

Disseminated Fusariosis in a Patient With Acute Myeloid Leukemia: A Case Report

“…In the immunocompetent, infection is frequently localized and presents as keratitis or onychomycosis [1-2,4]. However, in the immunocompromised, disseminated disease is more common and frequently fatal [1-2,5-6]. Differentiating this from other opportunistic fungal infections is important, as this pathogen is often more resistant to antifungals than the most common fungal opportunist, Aspergillus [1-2,6].…”

Multisystemic fusariosis with fulminant evolution

“…Invasive forms of fusariosis show cutaneous involvement in 63% of cases, and this is characterized by the presence of subcutaneous nodules, erythematous macules, or vesicle-pustules that may become necrotic. 4 , 7 This pathogen is highly angio-invasive, producing tissue infarctions such as those evidenced in the brain of the current patient, which generate intravascular sporulation, favoring a greater sensitivity of blood cultures in the final stages of the disease. 8 Fusarium spp.…”

“… 1 , 2 Immunosuppressed patients and carriers of hematologic malignancies are very susceptible to the development of invasive forms, showing high mortality. 2 , 3 , 4 This report describes the case of a patient with acute myeloid leukemia, who presented with invasive fusariosis with fulminant evolution after a bone marrow transplant.…”

First Demonstration of Clinical Fusarium Strains Causing Cross-Kingdom Infections from Humans to Plants

“…These fungi and their mycotoxins adversely affect approximately 80 economically important crops [ 8 ]. However, over the last 30 years, they have emerged as an opportunistic human pathogen, producing lethal systemic infections with a wide range of morbidities in superficial infections [ 9 , 10 ]. This change in epidemiology is likely due to a number of complex factors.…”