title: Fatal disseminated infection with Fusarium petroliphilum.
abstract: Members of the Fusarium solani species complex (FSSC) are causing the majority of the fusariosis in humans. Disseminated fusariosis has a high mortality and is predominantly observed in patients with leukemia. Here, we present the case of a fatal infection by a Fusarium strain with a degenerated phenotype, in a patient with acute lymphatic leukemia. Multiple nasal and skin biopsies as well as blood cultures yielded fungal growth, while in direct and histopathological examination of biopsy material septate hyphae were visible. Initial colonies were white with slimy masses with microconidia reminiscent of Fusarium/Acremonium, but with conidiospore production directly on the hyphae. Multi-locus sequence typing discerned a pionnotal-morphologically degenerated-colony of the recently recognized F. petroliphilum as etiological agent. The culture returned to a typical F. solani species complex morphology only after several weeks of growth in culture. Antifungal susceptibility tests indicate amphotericin B as best drug for this FSSC member rather than any of the azoles or echinocandins.
authors.affiliation: Department of Haematology, Faculty of Medicine, Uludağ University, Bursa, Turkey.
authors.forename: Tuba
authors.initials: T
authors.lastname: Ersal
authors.forename: Abdullah S M
authors.initials: AS
authors.lastname: Al-Hatmi
authors.forename: Burcu Dalyan
authors.initials: BD
authors.lastname: Cilo
authors.forename: Ilse
authors.initials: I
authors.lastname: Curfs-Breuker
authors.forename: Jacques F
authors.initials: JF
authors.lastname: Meis
authors.forename: Fahir
authors.initials: F
authors.lastname: Özkalemkaş
authors.forename: Beyza
authors.initials: B
authors.lastname: Ener
authors.forename: Anne D
authors.initials: AD
authors.lastname: van Diepeningen
mesh_terms: D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use*; D000077723:Cefepime; D002511:Cephalosporins / Q000627:therapeutic use; D017291:Clarithromycin / Q000627:therapeutic use; D025141:Drug Resistance, Fungal; D005260:Female; D060585:Fusariosis / Q000188:drug therapy* / Q000382:microbiology / Q000401:mortality*; D005670:Fusarium / Q000145:classification / Q000187:drug effects*; D006801:Humans; D064704:Levofloxacin / Q000627:therapeutic use; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D058885:Multilocus Sequence Typing; D016533:Mycological Typing Techniques; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use
chemical_list: D000935:Antifungal Agents; D002511:Cephalosporins; D064704:Levofloxacin; D000666:Amphotericin B; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D000077723:Cefepime; D017291:Clarithromycin