The emerging role of Fusarium infections in patients with cancer.
Infection due to Fusarium species is an increasing cause of serious potentially fatal disease in patients with cancer. We described 9 patients with infection caused by Fusarium species during a 4-year period at the M. D. Anderson Hospital. The spectrum of infections included disseminated disease in 4 patients, skin or soft-tissue infections in 3, pneumonia in 1, and fungemia in 1. All 4 patients with disseminated infection had culture- and biopsy-proven skin lesions caused by Fusarium species and the blood cultures yielded the organism in 3 of these 4 patients. Maxillary sinusitis was the presenting manifestation of Fusarium infection in 2 of these 4 patients, suggesting that paranasal sinuses are potential portals of entry for the infection. Eight patients had a hematological malignancy and 7 were neutropenic at the onset of their infection. Patients with deep-seated infections remained neutropenic and died from infection despite treatment with amphotericin B. All 5 isolates tested in vitro showed resistance to ketoconazole and miconazole, whereas 3 were susceptible to amphotericin B. Fusarium species could play a role in producing myelosuppression and fungal cultures are required to differentiate it from the more commonly encountered Aspergillus species. Fusarium species are emerging as a serious, potentially fatal, pathogen in patients with cancer.
Anaissie
E
E
Department of Internal Medicine, University of Texas, M. D. Anderson Hospital and Tumor Institute, Houston 77030.
Kantarjian
H
H
Ro
J
J
Hopfer
R
R
Rolston
K
K
Fainstein
V
V
Bodey
G
G
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000935:Antifungal Agents / Q000494:pharmacology; D005260:Female; D005670:Fusarium / Q000187:drug effects; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009181:Mycoses / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D009369:Neoplasms / Q000150:complications*
D000935:Antifungal Agents