title: Successful treatment of disseminated Fusarium infection in an immunocompromised child.
abstract: We report the first know case of disseminated fungal infection due to Fusarium proliferatum in a bone marrow transplant recipient to our knowledge. Fusarium was cultured from the blood, a paranasal sinus, and necrotic skin lesions. The isolate was sensitive to amphotericin B and on further sensitivity testing, synergy was demonstrated using rifampin in combination with amphotericin B. The patient had this infection while she was receiving alternate-day amphotericin, rifampin, and 5-flucytosine (5-FC) therapy. The infection was documented within 48 h of discontinuing daily granulocyte transfusions, which she had received for 3 weeks. The 5-FC was discontinued when sensitivities showed the organism resistant. After 6 weeks of treatment she showed complete remission of the infection, although neutrophil counts remained below 0.25 X 10(9)/L. From this case and from a review of the literature, it appears that synergic antifungal agents combined with leukocyte transfusions may be beneficial in the successful treatment of fusariosis in the compromised host.
authors.affiliation: Department of Pediatrics, Tulane University Medical School, New Orleans, Louisiana 70112.
authors.forename: N J
authors.initials: NJ
authors.lastname: Barrios
authors.forename: D V
authors.initials: DV
authors.lastname: Kirkpatrick
authors.forename: A
authors.initials: A
authors.lastname: Murciano
authors.forename: K
authors.initials: K
authors.lastname: Stine
authors.forename: R B
authors.initials: RB
authors.lastname: Van Dyke
authors.forename: J R
authors.initials: JR
authors.lastname: Humbert
mesh_terms: D000666:Amphotericin B / Q000008:administration & dosage / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001228:Aspergillosis / Q000150:complications; D016026:Bone Marrow Transplantation / Q000009:adverse effects; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005260:Female; D005670:Fusarium / Q000302:isolation & purification; D006801:Humans; D009181:Mycoses / Q000188:drug therapy* / Q000209:etiology; D009503:Neutropenia / Q000150:complications; D009894:Opportunistic Infections / Q000188:drug therapy* / Q000209:etiology; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications / Q000276:immunology / Q000628:therapy; D012293:Rifampin / Q000627:therapeutic use*; D012867:Skin / Q000382:microbiology; D001098:Spider Bites / Q000150:complications; D013203:Staphylococcal Infections / Q000150:complications
chemical_list: D000666:Amphotericin B; D012293:Rifampin