Infection withFusarium species in two children with neuroblastoma

Abstract

Two cases of Fusarium infection in children with neuroblastoma are reported. One of the patients had an overwhelming infection and the diagnosis was based on isolation of Fusarium moniliforme from blood and skin biopsy, and histological findings. The second patient developed chronic polyarthritis and Fusarium solani was cultured from synovial fluid samples taken from two different joints four months apart. No histological documentation of infection was obtained. The response to antifungal therapy was unfavourable. Both patients died, but in the second case the relationship between fungal infection and death was not established.

Taxonomy, biology, and clinical aspects of Fusarium species

“…while harvesting wheat (266). The patient responded to a total dose of 47 mg of amphotericin B per kg and right lower lobe lobectomy; several other cases of lung involvement were reported in the setting of disseminated fusariosis (26,243,265 At least 58 patients with disseminated fusarial infections have been reported (3,4,16,18,51,63,64,72,87,119,143,145,161,181,189,190,198,201,219,237 these patients was 32 years, with a range of 2 to 69 years. The male-to-female ratio was 2.6:1, without apparent predilection for race.…”

“…Upon recovery from myelosuppression, the infection may either resolve completely or become chronic and localized to sinuses, lungs, eye, brain, joint, or muscle (237), with the potential for relapse and dissemination upon reinstitution of cytotoxic chemotherapy (137). A small subset of patients with hlematogenous infection but without organ involvement has been observed (6).…”

“…Other human disorders and their possible association with Fusarium mycotoxins are summarized in Table 1. The trichothecenes (e.g., T-2 toxin, nivalenol, deoxynivalenol, and acetyldeoxynivalenol) are potent inhibitors of eukaryotic protein synthesis (135), and the target organs include actively dividing tissues such as bone marrow, lymph nodes, spleen, thymus, and intestinal mucosa (93,237). In vitro, T-2 toxin has been shown to have cytostatic (142) potential, to inhibit platelet aggregation (259), and to increase the prothrombin time (48).…”

Invasive mold infections in cancer patients: 5 years' experience withAspergillus, Mucor, Fusarium andAcremonium infections

“…have been known as truly human pathogens for years [4,6,7,12,13], but in the last 3 years a number of other hyphic genera have been isolated from infected human tissues, such as Fusarium spp. [21][22][23] (69 cases within the last 5 years), Acremoniurn spp. [9] (5 cases), Penicillium spp.…”

Efficacy of Liposomal Amphotericin B in Treatment of Systemic Murine Fusariosis

“…The increasing number of severe cases reported and the resistance to available antifungal drugs explain the clinical interest in these fungi. Fusarium verticillioides is, after Fusarium solani, the most common species causing fusariosis, which involves multiple organs, such as the liver, lung, kidney, heart, spleen, and pancreas, with a high mortality rate (8,9,21,22,25,27). To date, 15 cases of disseminated human infection by F. verticillioides have been reported, and more than 60% of them have shown a fatal outcome despite antifungal treatment (7,9,10,17).…”