Successful Outcome of Disseminated Fusarium Infection with Skin Localization Treated with Voriconazole and Amphotericin B-Lipid Complex in a Patient with Acute Leukemia

Parasitologie-Mycologie, Faculté de Médecine, CHRU de Lille, Lille, France.
Journal of Clinical Microbiology (Impact Factor: 3.99). 11/2003; 41(10):4898-900. DOI: 10.1128/JCM.41.10.4898-4900.2003
Source: PubMed


A disseminated Fusarium oxysporum infection with skin localization was diagnosed in a woman with a relapse of B-acute leukemia during induction chemotherapy.
The infection was refractory to amphotericin B-lipid complex alone but responded successfully when voriconazole was added.

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Available from: Serge Alfandari, Oct 14, 2015
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    • "To our knowledge, this is the first case reported in the literature of ecthyma gangrenosum-like lesions with simultaneous Pseudomonas sepsis and disseminated fusariosis. In the management of fusariosis, conventional or liposomal Amp B may be used singly; successful results were achieved also by combining it with voriconazole or posaconazole [8,9,10]. In the present case, voriconazole was combined with caspofungin instead of liposomal Amp B and complete response to treatment was achieved, with total resolution of cranial and pulmonary lesions. "
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    ABSTRACT: Fusarium spp. is an opportunistic mold that causes disseminated infections in immunocompromised patients. It is important to make a definite diagnosis because of high mortality rates. We present the case of a 27-year-old pregnant woman diagnosed with acute myeloid leukemia with a prolonged febrile neutropenic period. She developed ecthyma gangrenosum-like lesions and simultaneously had Pseudomonas bacteremia and disseminated fusariosis. Histopathological and microbiological features of skin lesions had a critical role in differential diagnosis. Ecthyma gangrenosum-like lesions due to disseminated fusariosis might be easily misdiagnosed as lesions associated with Pseudomonas unless tissue cultures and histopathological examinations are performed. Conflict of interest:None declared.
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