title: Invasive infection with Fusarium chlamydosporum in a patient with aplastic anemia.
abstract: We report the first case of invasive disease caused by Fusarium chlamydosporum. The patient had aplastic anemia with prolonged neutropenia and was treated with immunosuppressive therapy. While she was receiving empirical amphotericin B, a dark crusted lesion developed on her nasal turbinate. Histologic analysis revealed invasive hyaline hyphae and some darkly pigmented structures that resembled conidia of dematiaceous molds. Only after the mold was grown in culture were characteristic colonial morphology, phialides, conidia, and chlamydospores evident, thus permitting the identification of F. chlamydosporum. This case illustrates the ever-increasing spectrum of pathogenic Fusarium spp. in immunocompromised patients and emphasizes the potential pitfalls in histologic diagnosis, which may have important treatment implications.
authors.affiliation: Laboratory of Host Defenses, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland 20892, USA. bsegal@atlas.niaid.nih.gov
authors.forename: B H
authors.initials: BH
authors.lastname: Segal
authors.forename: T J
authors.initials: TJ
authors.lastname: Walsh
authors.forename: J M
authors.initials: JM
authors.lastname: Liu
authors.forename: J D
authors.initials: JD
authors.lastname: Wilson
authors.forename: K J
authors.initials: KJ
authors.lastname: Kwon-Chung
mesh_terms: D000328:Adult; D000666:Amphotericin B / Q000627:therapeutic use; D000741:Anemia, Aplastic / Q000150:complications*; D005260:Female; D005670:Fusarium / Q000254:growth & development / Q000302:isolation & purification*; D006801:Humans; D016867:Immunocompromised Host; D009181:Mycoses / Q000150:complications* / Q000175:diagnosis / Q000382:microbiology; D009503:Neutropenia / Q000209:etiology; D009666:Nose / Q000382:microbiology
chemical_list: D000666:Amphotericin B