Disseminated fusariosis in a patient with bone marrow aplasia

Abstract

Fusariosis is a superficial or systemic infection, which occurs mainly in immunocompromised hosts, especially in patients with hematological neoplasia; 70%–75% of the cases present cutaneous manifestations. The disseminated form is rare and difficult to diagnose; even with specific treatment, the evolution is usually fatal. Currently, it is considered an emerging disease; in some centers, it is the second most common cause of invasive mycosis, after aspergillosis. The authors describe a case of a female patient with idiopathic bone marrow aplasia and disseminated fusariosis, who initially appeared to benefit from voriconazole and amphotericin B; however, due to persistent neutropenia, her clinical condition deteriorated with fatal evolution.

Recommendations on the use of azole antifungals in hematology-oncology patients

“…The reduction in patient immunity resulting from the use of increasingly effective drugs in the treatment of serious diseases has led, inter alia, to an increase in the frequency and severity of invasive fungal infections. This circumstance is common in oncology patients, among whom hematology-oncology patients are a very special population as they commonly present with long-lasting neutropenia [1][2][3][4][5] Some genera of fungi are especially frequent in the genesis of invasive fungal infection. Candida, Aspergillus, Scedosporium, Fusarium and Mucorales are notable examples of pathogens with high mortality, both in general and in this type of patients: Candida exceeds 10% while the remaining pathogens, including Aspergillus, can exceed 50%.…”

“…In the same study, a concentration-dependent reduction in the QTc interval (-5.3 ms [ 90 % CI: - 9 . 4 , - 1 . 1 ] was observed at a C max of 719 ng/mL followed by a supratherapeutic dose of 1,680 mg [ 136 ].…”

“…4 , - 1 . 1 ] was observed at a C max of 719 ng/mL followed by a supratherapeutic dose of 1,680 mg [ 136 ].…”