title: Fusariosis in a Patient with Acute Myeloid Leukemia: A Case Report and Review of the Literature.
abstract: Fusarium spp. causes infections mostly in patients with prolonged neutropenia. We describe the case of a disseminated Fusarium solani infection in a patient with acute myeloid leukemia which never reached complete remission during its clinical course. The patient had profound neutropenia and developed skin nodules and pneumonia in spite of posaconazole prophylaxis. F. solani was isolated from blood and skin biopsy, being identified from its morphology and by molecular methods. By broth dilution method, the strain was resistant to azoles, including voriconazole and posaconazole, and to echinocandins. MIC to amphotericin B was 4 mg/L. The patient initially seemed to benefit from therapy with voriconazole and amphotericin B, but, neutropenia perduring, his clinical condition deteriorated with fatal outcome. All efforts should be made to determine the correct diagnosis as soon as possible in a neutropenic patient and to treat this infection in a timely way, assuming pathogen susceptibility while tests of antimicrobial susceptibility are pending. A review of the most recent literature on invasive fungal infections is reported.
authors.affiliation: Department of DETO, University of Bari, Bari, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Delia
authors.affiliation: Department SMBNOS, University of Bari, Bari, Italy. rosa.monno@uniba.it.
authors.forename: Rosa
authors.initials: R
authors.lastname: Monno
authors.affiliation: Department DIM, University of Bari, Bari, Italy.
authors.forename: Giorgia
authors.initials: G
authors.lastname: Giannelli
authors.affiliation: Department DIM, University of Bari, Bari, Italy.
authors.forename: Amato Antonio Stabile
authors.initials: AA
authors.lastname: Ianora
authors.affiliation: Department of DETO, University of Bari, Bari, Italy.
authors.forename: Lidia
authors.initials: L
authors.lastname: Dalfino
authors.affiliation: Department of DETO, University of Bari, Bari, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Pastore
authors.affiliation: Department SMBNOS, University of Bari, Bari, Italy.
authors.forename: Carmen
authors.initials: C
authors.lastname: Capolongo
authors.affiliation: Department SMBNOS, University of Bari, Bari, Italy.
authors.forename: Carla
authors.initials: C
authors.lastname: Calia
authors.affiliation: Department of Biomedical Science for Health, University of Milan, Milan, Italy.
authors.forename: Annamaria
authors.initials: A
authors.lastname: Tortorano
authors.affiliation: Department of DETO, University of Bari, Bari, Italy.
authors.forename: Giorgina
authors.initials: G
authors.lastname: Specchia
mesh_terms: D000328:Adult; D000666:Amphotericin B / Q000494:pharmacology / Q000627:therapeutic use; D000935:Antifungal Agents / Q000494:pharmacology / Q000627:therapeutic use; D001769:Blood / Q000382:microbiology; D017809:Fatal Outcome; D060585:Fusariosis / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology*; D005670:Fusarium / Q000187:drug effects / Q000302:isolation & purification*; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000150:complications*; D008168:Lung / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008826:Microbial Sensitivity Tests; D008828:Microbiological Techniques; D013902:Radiography, Thoracic; D012867:Skin / Q000382:microbiology; D014057:Tomography, X-Ray Computed; D014230:Triazoles / Q000494:pharmacology / Q000627:therapeutic use
chemical_list: D000935:Antifungal Agents; D014230:Triazoles; C101425:posaconazole; D000666:Amphotericin B
keywords: Fungal infection; Fusariosis; Fusarium; Leukemia