Fusarium Infection

Abstract

Fusarium species is a ubiquitous fungus that causes opportunistic infections. We present 26 cases of invasive fusariosis categorized according to the European Organization for Research and Treatment of Cancer/Mycoses Study Group (EORTC/MSG) criteria of fungal infections. All cases (20 proven and 6 probable) were treated from January 2000 until January 2010. We also review 97 cases reported since 2000. The most important risk factors for invasive fusariosis in our patients were compromised immune system, specifically lung transplantation (n = 6) and hematologic malignancies (n = 5), and burns (n = 7 patients with skin fusariosis), while the most commonly infected site was the skin in 11 of 26 patients. The mortality rates among our patients with disseminated, skin, and pulmonary fusariosis were 50%, 40%, and 37.5%, respectively. Fusarium solani was the most frequent species, isolated from 49% of literature cases. Blood cultures were positive in 82% of both current study and literature patients with disseminated fusariosis, while the remaining 16% had 2 noncontiguous sites of infection but negative blood cultures. Surgical removal of focal lesions was effective in both current study and literature cases.Skin lesions in immunocompromised patients should raise the suspicion for skin or disseminated fusariosis. The combination of medical monotherapy with voriconazole or amphotericin B and surgery in such cases is highly suggested.

International Evaluation of MIC Distributions and Epidemiological Cutoff Value (ECV) Definitions for Fusarium Species Identified by Molecular Methods for the CLSI Broth Microdilution Method

“…Although case series of Fusarium infections have been reported throughout the years (4,7,9,16,(20)(21)(22), only in a recent report was an indication of a potential correlation between MICs for Fusarium spp. and response to treatment found (22), where CLSI MICs for seven Fusarium isolates identified by molecular methods, antifungal therapy (voriconazole or both voriconazole and amphotericin B), and clinical response were documented for patients with invasive fusariosis.…”

“…The most frequent causes of fungal infections are members of three complexes, the F. solani species complex (SC), the F. oxysporum SC, and the Fusarium (Gibberella) fujikuroi SC (which includes, among others, F. verticillioides and F. proliferatum), and the next most frequent causes belong to the F. dimerum SC and F. incarnatum-F. equiseti SC; their distribution could be region dependent (4,(7)(8)(9)(10). Common clinical presentations are onychomycosis, keratitis, allergic disease (sinusitis and bronchopulmonary disease) for nonimmunocompromised patients and disseminated disease, as well as other severe invasive infections, in immunocompromised hosts (e.g., patients with prolonged neutropenia and T-cell immunodeficiency) (1,4,(7)(8)(9)(10)(11)(12)(13). Amphotericin B lipid formulations, voriconazole, posaconazole, and, to a lesser extent, itraconazole have been recommended or used for the treatment and prophylaxis of Fusarium infections, in addition to surgical debridement and reversal of immunosuppression (14)(15)(16)(17)(18)(19).…”

“…However, the perception is that new generic changes may be suggested, such as the establishment of the genus Bisifusarium to include the more commonly known members of the Fusarium dimerum SC and the name Neocosmospora solani to replace Fusarium solani (6). The most frequent causes of fungal infections are members of three complexes, the F. solani species complex (SC), the F. oxysporum SC, and the Fusarium (Gibberella) fujikuroi SC (which includes, among others, F. verticillioides and F. proliferatum), and the next most frequent causes belong to the F. dimerum SC and F. incarnatum-F. equiseti SC; their distribution could be region dependent (4,(7)(8)(9)(10). Common clinical presentations are onychomycosis, keratitis, allergic disease (sinusitis and bronchopulmonary disease) for nonimmunocompromised patients and disseminated disease, as well as other severe invasive infections, in immunocompromised hosts (e.g., patients with prolonged neutropenia and T-cell immunodeficiency) (1,4,(7)(8)(9)(10)(11)(12)(13).…”

Global molecular epidemiology and genetic diversity of Fusarium , a significant emerging group of human opportunists from 1958 to 2015

“…10, 11, 12, 13, 14, 15, 16 Nucci et al 17 reported 233 cases from different hospitals on a global scale. Mohammed et al 18 reported 26 cases from the United States and reviewed 97 cases from the literature, and Horn et al 12 described 65 cases from the North American Path Alliance Registry. A major problem in comparative studies is the subdivision of the classical species into a series of molecular siblings, which renders the older literature without sequence data uninterpretable.…”

Mycoses and Antifungals: reviewing the basis of a current problem that still is a biotechnological target for marine products

“…In the recent years other fungi emerged as important infections agents, including yeast species such as non-albicans Candida species, Cryptococcus sp., Trichosporon spp., and Rhodotorula spp. and filamentous fungi such as Fusarium spp., Rhizopus spp., Rhizomucor spp., and phaeohyphomycosis agents (Sun et al, 2012;Juyal et al, 2013;Kim et al, 2013;Muhammed et al, 2013;Jaın et al, 2014;Schieffelin et al, 2014).…”