title: Successful treatment of disseminated Fusarium infection in an infant with leukemia.
abstract: Disseminated Fusarium infection in an immunocompromised host is intractable and results in high mortality. We provide the first full case report on successful treatment of a disseminated Fusarium infection in an infant. The 6-month-old infant, whose family raised livestock, had infantile leukemia. During the neutropenic period after intensive chemotherapy, vomiting, diarrhea, fever, subcutaneous nodes, and coughing appeared. Pneumonia was diagnosed, and Fusarium moniliforme was isolated from blood culture. A central venous catheter was removed. Granulocyte colony-stimulating factor (G-CSF) and amphotericin B (AMPH-B) (total dose, 65 mg/kg) were administered continuously for 8 weeks. The infection was resolved according to improvement of clinical and laboratory findings, and intensive chemotherapy was restarted for the leukemia. Cord blood stem cell transplantation from an unrelated donor was performed. The Fusarium infection did not recur, but after transplantation, leukemia relapsed. Treatment of neutrophils using G-CSF, AMPH-B, and local treatment induced resolution of the disseminated Fusarium infection in this immunocompromised host with malignancy. We suggest caution for patients living in an environment conducive to the development of Fusarium infection because of the particular risk of infection.
authors.affiliation: Department of Pediatrics, Kagawa Medical University, Miki, Kita-gun, Kagawa, 761-0793 Japan. hiokada@kms.ac.jp
authors.forename: H
authors.initials: H
authors.lastname: Okada
authors.forename: S
authors.initials: S
authors.lastname: Hamatani
authors.forename: M
authors.initials: M
authors.lastname: Kondo
authors.forename: T
authors.initials: T
authors.lastname: Imai
authors.forename: S
authors.initials: S
authors.lastname: Itoh
authors.forename: K
authors.initials: K
authors.lastname: Isobe
authors.forename: S
authors.initials: S
authors.lastname: Onishi
mesh_terms: D000666:Amphotericin B / Q000008:administration & dosage; D000818:Animals; D000829:Animals, Domestic / Q000382:microbiology; D000935:Antifungal Agents / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects; D005670:Fusarium; D006801:Humans; D016867:Immunocompromised Host; D007223:Infant; D007938:Leukemia / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology; D008297:Male; D009181:Mycoses / Q000188:drug therapy* / Q000209:etiology*
chemical_list: D000935:Antifungal Agents; D000666:Amphotericin B