A case of fusariosis in an immunocompromised patient successfully treated with liposomal amphotericin B.
Although aspergillosis remains the most common mould infection in patients with haematologic malignancies, disseminated Fusarium infection is an emerging problem with a poor prognosis in this patient population. The treatment options are limited due to relative resistance of the fungus to standard antifungals. We present a patient with acute lymphoblastic leukaemia successfully treated with AmBisome for a disseminated Fusarium solani infection that did not respond to first line treatment with voriconazole. Despite the fact that he received additional myelosuppressive chemotherapy and underwent two stem cell transplantations from HLA mismatched donors the Fusarium infection did not recur during the subsequent phases of neutropenia. The clinical presentation, diagnosis, prognosis and therapeutic options of fusariosis in immunocompromised patients are briefly discussed.
Selleslag
Dominik
D
AZ Sint-Jan AV, Department of Haematology, Brugge, Belgium. dominik.selleslag@azbrugge.be
D000038:Abscess / Q000188:drug therapy* / Q000382:microbiology; D000666:Amphotericin B / Q000008:administration & dosage / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000008:administration & dosage; D058846:Antibodies, Monoclonal, Murine-Derived; D000935:Antifungal Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D001549:Benzamides; D003131:Combined Modality Therapy; D003561:Cytarabine / Q000008:administration & dosage; D005533:Foot Dermatoses / Q000188:drug therapy / Q000382:microbiology; D005670:Fusarium / Q000187:drug effects / Q000302:isolation & purification*; D006801:Humans; D000068877:Imatinib Mesylate; D016867:Immunocompromised Host; D008081:Liposomes; D008297:Male; D008875:Middle Aged; D009135:Muscular Diseases / Q000188:drug therapy* / Q000382:microbiology; D014009:Onychomycosis / Q000188:drug therapy* / Q000382:microbiology; D036102:Peripheral Blood Stem Cell Transplantation; D010879:Piperazines / Q000008:administration & dosage; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications* / Q000188:drug therapy; D011743:Pyrimidines / Q000008:administration & dosage / Q000627:therapeutic use; D012008:Recurrence; D012074:Remission Induction; D012086:Reoperation; D000069283:Rituximab; D013713:Teniposide / Q000008:administration & dosage; D014230:Triazoles / Q000627:therapeutic use; D065819:Voriconazole
D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D000935:Antifungal Agents; D001549:Benzamides; D008081:Liposomes; D010879:Piperazines; D011743:Pyrimidines; D014230:Triazoles; C068538:liposomal amphotericin B; D003561:Cytarabine; D000069283:Rituximab; D000666:Amphotericin B; D000068877:Imatinib Mesylate; D013713:Teniposide; D065819:Voriconazole