Fusarium proliferatum-induced chronic lip ulcer: successful treatment with itraconazole: a case report

Abstract

Background Fusarium species are saprophytic fungi with a worldwide distribution. These fungi cause various infections among immunocompromised patients; however, they can also involve immunocompetent individuals. Case presentation We report a case of a 41-year-old Iranian woman who presented with ulcerative lesions on her lips 10 months ago. She had a long history of anxiety but had no history of classical risk factors such as trauma, cosmetic lip tattoo, burning in her lips, smoking or use of alcohol and opium. A skin biopsy from the lower lip was performed and sent for microbiological examinations. Hyaline septate hyphae were seen on direct microscopy with potassium hydroxide. The clinical specimen was subcultured on sabouraud dextrose agar with chloramphenicol and prepared for antifungal susceptibility testing and molecular identification. Considering the minimum inhibitory concentrations (MIC) for antifungals, itraconazole (100 mg orally twice a day) was started for her, and after 2 months, the lesions were treated. She followed up for 3 months, and no signs of disease recurrence were observed. Conclusions Selecting an appropriate treatment strategy according to the laboratory assessments is essential in clinical practice and the management of rare infections to prevent related mortality and morbidity of opportunistic fungal infections.

Clinical spectrum of fusariosis from a tertiary care center in India- a retrospective study

“…The majority of the infections occur in patients with hematological malignancy (3, 6, 15, 16). Fusarium infections are considered rare in immunocompetent individuals ( 17 , 18 ). In a large review of cutaneous infections caused by fusariosis, only 10% of the patients were immunocompetent ( 15 ).…”

“…In a review of 259 cases of cutaneous lesions, the lesions were slowly progressive and preceded by skin breakdown in immunocompetent, but were rapidly progressive without any preceding injury in immunocompromised individuals ( 15 ). There are case reports of leg ulcers ( 17 ) and lip ulcer ( 18 ) with Fusarium spp. In the present study, Fusarium spp.…”

Paracoccidioidomycosis after eyebrow micropigmentation: Unusual reactivation or a new form of transmission by cutaneous inoculation?

“…and Fusarium sp. [ [5] , [6] , [7] , [8] , [9] , [10] , [11] ]. Sporotrichosis is a subcutaneous mycosis mainly transmitted by direct inoculation and a so-called implantation mycosis.…”

Simultaneous infection with Fusarium proliferatum and Prototheca wickerhamii localized at different body sites

“…For mucocutaneous manifestations of the infection, the most common are umbilicated papules, pustules, cellulitis, and subcutaneous nodules [ 8 ]. In most localized deep infections, a history of direct trauma is an important clue for infection [ 9 ]. In the case the patient also had a traumatic trigger, this could be the portal of infection.…”