Disseminated infection due to Cylindrocarpon (Fusarium) lichenicola in a neutropenic patient with acute leukaemia: report of a case and review of the literature.
Described here is an unusual case of disseminated Cylindrocarpon lichenicola (Fusarium lichenicola) infection originating from a toenail lesion of a neutropenic woman with cellulitis of the foot and underlying acute leukaemia. A computed tomography scan of the chest showed multiple, ill-defined, nodular infiltrates with alveolar consolidation. The fungus was isolated from both the nail and the skin of the infected toe. Susceptibility testing revealed low minimum inhibitory concentrations for amphotericin B (0.78 micro g/ml) and voriconazole (1.56 micro g/ml) and high minimum inhibitory concentrations (>100 micro g/ml) for fluconazole, ketoconazole and itraconazole. The infection resolved after treatment with a total dose of 1 g of amphotericin B followed by oral itraconazole and bone marrow regeneration.
Rodríguez-Villalobos
H
H
Department of Microbiology, Hôpital Erasme-ULB, route de Lennik 808, 1070 Brussels, Belgium. hrodrigu@ulb.ac.be
Georgala
A
A
Beguin
H
H
Heymans
C
C
Pye
G
G
Crokaert
F
F
Aoun
M
M
D000368:Aged; D000935:Antifungal Agents / Q000627:therapeutic use; D002481:Cellulitis / Q000188:drug therapy / Q000382:microbiology*; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D016523:Foot Ulcer / Q000188:drug therapy / Q000382:microbiology*; D016469:Fungemia / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D005670:Fusarium / Q000302:isolation & purification*; D006801:Humans; D009503:Neutropenia / Q000276:immunology*; D009894:Opportunistic Infections / Q000188:drug therapy / Q000276:immunology / Q000382:microbiology*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000175:diagnosis / Q000276:immunology*; D018570:Risk Assessment; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D000935:Antifungal Agents