[Successful treatment with voriconazole for disseminated cutaneous and visceral infection by Fusarium solani in a patient with acute myeloid leukemia].
We report the successful treatment of a disseminated Fusarium infection with skin manifestations in a severely neutropenic patient. A 51-year-old man with acute myeloblastic leukemia (M4) underwent two courses of remission induction therapy with cytarabine and daunorubicin. Despite prophylactic treatment with tosufloxacin and micafungin, the patient developed a febrile scrotal ulcer. Eight days later, we noted the appearance of painful and diffuse cutaneous nodules and a plain chest X-ray disclosed multiple nodular lesions. Microbiological examination of the scrotal ulcer revealed infection by Fusarium solani, which was also confirmed by both histological and microbiological examination of the skin nodules. Although the patient was treated with amphotericin B (AMPH-B), the clinical symptoms worsened. After AMPH-B was replaced with voriconazole (VRCZ), the patient's symptoms and chest radiographic findings dramatically improved. Thus, VRCZ might be an alternative therapy for patients with neutropenia who have fusariosis that is refractory or unresponsive to AMPH-B.
Muramatsu
Takashi
T
Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital.
Ueki
Toshimitsu
T
Ohashi
Kazuteru
K
Negishi
Kumiko
K
Suzuki
Tomokazu
T
Shitara
Minori
M
Honma
Misao
M
Ito
Tateki
T
Sakai
Miwa
M
Yamashita
Takuya
T
Akiyama
Hideki
H
Sakamaki
Hisashi
H
D000935:Antifungal Agents / Q000627:therapeutic use*; D003881:Dermatomycoses / Q000150:complications* / Q000188:drug therapy*; D005670:Fusarium; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000150:complications*; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000150:complications* / Q000188:drug therapy*; D009894:Opportunistic Infections / Q000150:complications* / Q000188:drug therapy*; D011743:Pyrimidines / Q000627:therapeutic use*; D016896:Treatment Outcome; D014230:Triazoles / Q000627:therapeutic use*; D065819:Voriconazole
D000935:Antifungal Agents; D011743:Pyrimidines; D014230:Triazoles; D065819:Voriconazole