title: Disseminated fusariosis in immunocompromised patients.
abstract: Immunocompromised patients are at high risk of developing serious disseminated infections by opportunistic fungi (Aspergillus, Candida, and Fusarium spp), which frequently present as cutaneous lesions, sometimes as a first sign. Prolonged and deep neutropenia, immunodepressive treatments (systemic steroids and chemotherapy) and severe T-cell immunodeficiency are the most important risk factors. We report 2 patients with acute lymphoblastic leukemia, who developed multiple tender erythematous skin lesions on their legs and arms during chemotherapy treatment. Skin biopsies for histology and culture studies established the diagnosis of Fusarium infection. They received treatment with systemic antifungal and granulocyte colony-stimulting factor. The infection responded after recovering from neutropenia. Early diagnosis and treatment is very important to improve the prognosis, because these infections in immunodepressed hosts have a high mortality rate.
authors.affiliation: Department of Dermatology, Hospital Clínico Universitario de Valencia, University of Valencia Av. Blasco Ibáñez, Valencia, Spain. ev_gutierrez@hotmail.com
authors.forename: Eva María
authors.initials: EM
authors.lastname: Gutiérrez Paredes
authors.forename: Lucía
authors.initials: L
authors.lastname: Gámez Pérez
authors.forename: Antonio Javier
authors.initials: AJ
authors.lastname: González Rodríguez
authors.forename: Dolores
authors.initials: D
authors.lastname: Ramón Quiles
authors.forename: Carlos
authors.initials: C
authors.lastname: Monteagudo Castro
authors.forename: Esperanza
authors.initials: E
authors.lastname: Jordá Cuevas
mesh_terms: D000666:Amphotericin B / Q000008:administration & dosage / Q000493:pharmacokinetics*; D000935:Antifungal Agents / Q000008:administration & dosage; D017809:Fatal Outcome; D005260:Female; D060585:Fusariosis / Q000276:immunology*; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D008875:Middle Aged; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy*; D011743:Pyrimidines / Q000008:administration & dosage; D014230:Triazoles / Q000008:administration & dosage; D065819:Voriconazole; D055815:Young Adult
chemical_list: D000935:Antifungal Agents; D011743:Pyrimidines; D014230:Triazoles; D016179:Granulocyte Colony-Stimulating Factor; D000666:Amphotericin B; D065819:Voriconazole