Disseminated fusariosis.
A 7-year-old boy with T cell acute lymphoblastic leukemia developed disseminated hyalohyphomycosis due to Fusarium solani. The clinical features included fever, severe myalgia, documented fungemia with F. solani, an ecthyma gangrenosum-like lesion next to a peripheral venous catheter, and disseminated pustules. Severe neutropenia due to chemotherapy was the most relevant risk factor. Histopathologic study of the ecthyma gangrenosum-like lesion, as well as pustular lesions, revealed epidermal necrosis and an inflammatory infiltrate in the upper dermis, with numerous septate hyphae demonstrated by periodic acid-Schiff stain. Clinical resolution was achieved with granulocyte colony-stimulating factor and amphotericin B administration. Our case suggests that the peripheral venous access was probably the portal of entry of the fungus.
Repiso
T
T
Department of Dermatology, Hospital Vall d'Hebrón, Barcelona, Spain.
García-Patos
V
V
Martin
N
N
Creus
M
M
Bastida
P
P
Castells
A
A
D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D002406:Catheterization, Peripheral / Q000295:instrumentation; D002648:Child; D003881:Dermatomycoses / Q000175:diagnosis* / Q000188:drug therapy; D004473:Ecthyma / Q000382:microbiology; D005334:Fever / Q000175:diagnosis; D016469:Fungemia / Q000175:diagnosis; D005670:Fusarium; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use; D006801:Humans; D015459:Leukemia-Lymphoma, Adult T-Cell / Q000188:drug therapy; D008297:Male; D009135:Muscular Diseases / Q000175:diagnosis; D009503:Neutropenia / Q000139:chemically induced
D000935:Antifungal Agents; D016179:Granulocyte Colony-Stimulating Factor; D000666:Amphotericin B