<i>Acremonium</i> pyomyositis in a pediatric patient with acute leukemia

Chang, Yu-Hsiang; Huang, Li‐Min; Hsueh, Po-Ren; Hsiao, Cheng–Hsiang; Peng, Steven Shinn-Forng; Yang, Rong‐Sen; Lin, Kai‐Hsin

doi:10.1002/pbc.20276

Cited by 17 publications

(18 citation statements)

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“…In children, disseminated Fusarium infections are still very rare 8–10. Another fungal pathogen, Acremonium (formerly Cephalosporium ), has been reported in a total of 44 cases, with a mortality rate of 30% 11–15. The optimal treatment strategy of these fungal pathogens has not yet been established.…”

Section: Introductionmentioning

confidence: 99%

Lethal double infection with Acremonium strictum and Aspergillus fumigatus during induction chemotherapy in a child with ALL

Fischer

Seibold

Borneff-Lipp

et al. 2006

Pediatric Blood & Cancer

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Fungal infections are a major cause of morbidity and mortality in patients during chemotherapeutic treatments and malignant hematologic disease. We present a case of a double fungal infection with disseminated Acremonium strictum (A. strictum) and pulmonary Aspergillus fumigatus (A. fumigatus) and its rapid clinical course. A 17-year-old boy with prolonged neutropenia developed a disseminated fungal infection during induction chemotherapy of his acute lymphoblastic leukemia. The infection was rapidly lethal despite neutrophil recovery and early antifungal combination therapy with amphotericin B and caspofungin. Since there are only a few reports about invasive Acremonium infections, we present this case with regard to differences in the clinic pathologic features of Aspergillosis and other opportunistic fungal infections due to Fusarium or Acremonium species.

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Section: Introductionmentioning

confidence: 99%

Lethal double infection with Acremonium strictum and Aspergillus fumigatus during induction chemotherapy in a child with ALL

Fischer

Seibold

Borneff-Lipp

et al. 2006

Pediatric Blood & Cancer

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“…32 Penetrating trauma remains the major cause of primary cutaneous zygomycosis (Table 2). [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] Other causes reported include elasticized bandages and wound dressings, 55 burns, 56 motor vehicle collision, 57 intravenous access, 58 and dog bite. 59 Our case report of primary cutaneous mucormycosis after a cat bite is a rare finding.…”

Section: Discussionmentioning

confidence: 99%

“…66 The higher overall mortality rate of 29.4% seen in the review of the literature was observed more frequently in patients with neutropenia (60.0%) and without surgical intervention (73.3%), and the survival rate was higher (35.3%) for cases utilizing both antifungal and surgical interventions. [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] The antifungal agent with the highest survival rate was amphotericin B and its formulations (58.8%). [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] …”

Section: Discussionmentioning

confidence: 99%

“…[5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] In patients with hematological malignancy and primary cutaneous mold infection, outcomes were determined on whether or not the infection was localized vs disseminated. [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] In cases in which the infection remained localized, 100% of patients recov- ered; by contrast, in cases of disseminated infection, the mortality rate was 29.4%. [5][6][7][8][9][10][11][12][13][14][15][16][17]…”

Section: Literature Reviewmentioning

confidence: 99%

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Primary Gangrenous Cutaneous Mold Infections in a Patient with Cancer and Neutropenia

et al. 2016

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“…Localized infections, such as mycetoma, keratitis, or onychomycosis, are acquired mainly by immunocompetent patients through trauma (5)(6)(7)(8)(9)(10)(11). Invasive infections generally affect immunosuppressed hosts such as those undergoing transplantation or those with AIDS, resulting in a high degree of fatality (12)(13)(14)(15)(16). More rarely, though, invasive infections have also been reported in immunocompetent individuals (17,18).…”

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confidence: 99%

Evaluation of the Efficacies of Amphotericin B, Posaconazole, Voriconazole, and Anidulafungin in a Murine Disseminated Infection by the Emerging Opportunistic Fungus Sarocladium (Acremonium) kiliense

Fernández-Silva

Capilla²,

Mayayo³

et al. 2013

Antimicrob Agents Chemother

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We evaluated and compared the efficacies of different antifungal drugs against Sarocladium kiliense (formerly Acremonium kiliense), a clinically relevant opportunistic fungus, in a murine model of systemic infection. Three clinical strains of this fungus were tested, and the therapy administered was as follows: posaconazole at 20 mg/kg of body weight (twice daily), voriconazole at 40 mg/kg, anidulafungin at 10 mg/kg, or amphotericin B at 0.8 mg/kg. The efficacy was evaluated by prolonged animal survival, tissue burden reduction, and (1¡3)-␤-D-glucan serum levels. In general, the four antifungal drugs showed high MICs and poor in vitro activity. The efficacy of the different treatments was only modest, since survival rates were never higher than 40% and no drug was able to reduce fungal load in all the organs for the three strains tested. Posaconazole, in spite of its high MICs (>16 g/ ml), showed the highest efficacy. The (1¡3)-␤-D-glucan serum levels were equally reduced by all drugs evaluated.A cremonium kiliense is a saprobic fungus with a worldwide distribution which has been reported in recent years as an emerging opportunistic pathogen able to cause a wide range of human infections (1-4). Localized infections, such as mycetoma, keratitis, or onychomycosis, are acquired mainly by immunocompetent patients through trauma (5-11). Invasive infections generally affect immunosuppressed hosts such as those undergoing transplantation or those with AIDS, resulting in a high degree of fatality (12-16). More rarely, though, invasive infections have also been reported in immunocompetent individuals (17,18). Recently, based on molecular studies, this fungus has been transferred to the genus Sarocladium as Sarocladium kiliense (1). This species is the most clinically relevant of the genus and apparently also the most virulent (4,19,20). Considering that the morphological identification of these fungi is difficult, it is likely that some clinical isolates of this species have been misidentified as Acremonium strictum, another clinically important species of Acremonium (19). Infections by Acremonium spp. are difficult to treat due to the intrinsic resistance to the current antifungal agents, and an effective treatment has not yet been determined (19,(21)(22)(23). Amphotericin B (AMB) is the drug most commonly used to treat severe fungal infections caused by opportunistic molds (4). Despite its poor in vitro activity and variable clinical results, this drug still remains the first therapeutic choice against invasive Acremonium infections (2, 4, 19). Clinical experience with other drugs, such as posaconazole (PSC), voriconazole (VRC), and the echinocandins, is very poor.To evaluate possible therapeutic strategies, we tested the efficacies of PSC, VRC, and anidulafungin (AFG) compared to that of AMB against S. kiliense in a recently developed murine model of disseminated infection (20). MATERIALS AND METHODSThree clinical strains of Sarocladium kiliense, UTHSC 01-2238, UTHSC 03-3197, and UTHSC 07-550, previously identified by...

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Acremonium pyomyositis in a pediatric patient with acute leukemia

Cited by 17 publications

References 18 publications

Lethal double infection with Acremonium strictum and Aspergillus fumigatus during induction chemotherapy in a child with ALL

Lethal double infection with Acremonium strictum and Aspergillus fumigatus during induction chemotherapy in a child with ALL

Primary Gangrenous Cutaneous Mold Infections in a Patient with Cancer and Neutropenia

Evaluation of the Efficacies of Amphotericin B, Posaconazole, Voriconazole, and Anidulafungin in a Murine Disseminated Infection by the Emerging Opportunistic Fungus Sarocladium (Acremonium) kiliense

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