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

Abstract

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.

First Comprehensive Report of Clinical Fusarium Strains Isolated in the State of Sao Paulo (Brazil) and Identified by MALDI-TOF MS and Molecular Biology

“…Molecular techniques are the most frequently identification methods because of species specificity of this region. The technique is known to provide good resolution at the sub-species level, and thus sequence analysis is a superior choice for phylogeny in Fusarium species complexes [13,36,37].…”

“…clinical isolates. In addition, ITS sequencing is known to provide good resolution and a superior choice for phylogenetic studies in the species complex [13,[37][38][39]. However, the high-throughput sequencing of Fusarium spp.…”

“…There is an increasing incidence of infections related to immunosuppressed patients (e.g., elderly, AIDS, solid organ, and bone marrow transplantation; oncological, hematological, and autoimmune diseases) [10,11]. The number of subcutaneous fusarioses has increased at alarming levels, making fusariosis, after aspergillosis, the second most common filamentous fungal infection in patients with hematologic neoplasms [12][13][14].…”

Flow Cytometry Is a Powerful Tool for Assessment of the Viability of Fungal Conidia in Metalworking Fluids

“…Fusariosis is mainly associated with locally invasive symptoms such as keratitis and onychomycosis. Nevertheless, the fungus can also spread, causing disseminated infections (16,17). Fusariosis is mainly caused by members of the Fusarium solani species complex (SC) and the F. oxysporum SC.…”

The Curious Case of “Case Report” of Infections Caused by Human and Animal Fungal Pathogens: An Educational Tool, an Online Archive, or a Format in Need of Retooling

“…Severe paracoccidioidomycosis in a 14-year-old boy 200 1/1 [63] a Google Scholar/Scopus [41,42], France [43,44], India [45,46], Italy [47], Iran [48], Japan [49], Malaysia [50], Poland [51], UK [52], and USA [53,54]. There were no other discernible features among this group of case reports to account for the high downloads and citations except for a novelty or rarity of fungal pathogens, for example reports of two cases of multidrug-resistant yeast (Fereydounia khargensis) and of black-grain eumycetoma caused by the rare fungal pathogen Medicopsis romeroi [50,52].…”