학술논문
Fusariosis in a Patient with Acute Myeloid Leukemia: A Case Report and Review of the Literature
Article
Article
Document Type
Academic Journal
Author
Source
Mycopathologia. June 2016, Vol. 181 Issue 5-6, p457, 7 p.
Subject
Language
English
ISSN
0301-486X
Abstract
Author(s): Mario Delia[sup.1] , Rosa Monno[sup.2] , Giorgia Giannelli[sup.3] , Amato Antonio Stabile Ianora[sup.3] , Lidia Dalfino[sup.1] , Domenico Pastore[sup.1] , Carmen Capolongo[sup.2] , Carla Calia[sup.2] , Annamaria Tortorano[sup.4] , [...]
Fusarium spp. causes infections mostly in patients with prolonged neutropenia. We describe the case of a disseminated Fusariumsolani 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.
Fusarium spp. causes infections mostly in patients with prolonged neutropenia. We describe the case of a disseminated Fusariumsolani 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.