[Disseminated fusarium infection in two neutropenic children].
Disseminated fusariosis in children is a rare and serious fungal infection, that occurs especially in neutropenic immunosuppressed patients, treated for malignant hemopathy, or bone marrow transplant recipient. Treatment is difficult and mortality is estimated between 50 and 70% in adult patients. CASE REPORT 1: A ten-year-old boy, treated for an acute lymphoblastic leukemia in second relapse, presented a disseminated fusarium spp infection, that occurred during neutropenia. He died due to fusariosis infection in spite of amphotericin B treatment. CASE REPORT 2: A ten-year-old neutropenic girl, treated for an acute myeloïd leukemia, presented disseminated fusariosis, uncontrolled by amphotericin B. Recovery was observed after voriconazole introduction and resolution of neutropenia. Ten months later, she presented a leukemia's relapse, treated by new intensive chemotherapy with secondary prophylaxis by voriconazole, without fusariosis's recurrence.


CONCLUSIONS
Voriconazole, a new triazole agent, seems to be an alternative antifungal agent to amphotericin B for disseminated fusarium infection, either at the acute phase or for secondary prophylaxis.
Petit
A
A
Service d'hématologie et d'oncologie pédiatrique, hôpital d'enfants Armand-Trousseau, Assistance-publique-Hôpitaux de Paris, France.
Tabone
M D
MD
Moissenet
D
D
Auvrignon
A
A
Landman-Parker
J
J
Boccon-Gibod
L
L
Leverger
G
G
D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D002648:Child; D004338:Drug Combinations; D017809:Fatal Outcome; D005260:Female; D005670:Fusarium / Q000302:isolation & purification*; D006801:Humans; D016867:Immunocompromised Host; D007945:Leukemia, Lymphoid / Q000150:complications / Q000188:drug therapy / Q000276:immunology; D007951:Leukemia, Myeloid / Q000150:complications / Q000188:drug therapy / Q000276:immunology; D008297:Male; D009181:Mycoses / Q000188:drug therapy / Q000209:etiology* / Q000276:immunology / Q000382:microbiology; D009503:Neutropenia / Q000139:chemically induced / Q000150:complications*; D011743:Pyrimidines / Q000627:therapeutic use; D014230:Triazoles / Q000627:therapeutic use; D065819:Voriconazole
D000935:Antifungal Agents; D004338:Drug Combinations; D011743:Pyrimidines; D014230:Triazoles; D000666:Amphotericin B; D065819:Voriconazole