Primary disseminated fusarial infection

M, Madhavan; Ratnakar, C.; Veliath, A. J.; Kanungo, Reba; Smile, S. R.; Bhat, Shyamasunder N

doi:10.1136/pgmj.68.796.143

Cited by 26 publications

(11 citation statements)

References 16 publications

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“…Peritonitis in patients receiving continuous ambulatory peritoneal dialysis has also been described (34,52,92). Other infections in immunocompetent patients include sinusitis (56), pneumonia (62,97), thrombophlebitis (69), fungemia with or without organ involvement (74,104), endophtalmitis (35,86), septic arthritis (51), and osteomyelitis (10). Two recent outbreaks of fusarial keratitis were recently described in the United States (164 cases) and Singapore (66 cases).…”

Section: Epidemiology and Clinical Spectrum Of Fusariosismentioning

confidence: 99%

Fusarium Infections in Immunocompromised Patients

2007

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SUMMARY Fusarium species cause a broad spectrum of infections in humans, including superficial, locally invasive, and disseminated infections. The clinical form of fusariosis depends largely on the immune status of the host and the portal of entry, with superficial and localized disease occurring mostly in immunocompetent patients and invasive and disseminated disease affecting immunocompromised patients. Risk factors for severe fusariosis include prolonged neutropenia and T-cell immunodeficiency, especially in hematopoietic stem cell transplant recipients with severe graft-versus-host disease. The most frequent presentation of disseminated fusariosis is a combination of characteristic cutaneous lesions and positive blood cultures, with or without lung or sinus involvement. The prognosis is poor and is determined largely by degree of immunosuppression and extent of infection, with virtually a 100% death rate among persistently neutropenic patients with disseminated disease. These infections may be clinically suspected on the basis of a constellation of clinical and laboratory findings, which should lead to prompt therapy. Treatment options include the lipid formulations of amphotericin B, voriconazole, and posaconazole. Prevention of fusarial infection among high-risk patients should be considered.

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Section: Epidemiology and Clinical Spectrum Of Fusariosismentioning

confidence: 99%

Fusarium Infections in Immunocompromised Patients

2007

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“…while harvesting wheat (266). The patient responded to a total dose of 47 mg of amphotericin B per kg and right lower lobe lobectomy; several other cases of lung involvement were reported in the setting of disseminated fusariosis (26,243,265 At least 58 patients with disseminated fusarial infections have been reported (3,4,16,18,51,63,64,72,87,119,143,145,161,181,189,190,198,201,219,237 these patients was 32 years, with a range of 2 to 69 years. The male-to-female ratio was 2.6:1, without apparent predilection for race.…”

Section: Pathogenesis Of Infectionmentioning

confidence: 99%

“…The prevalence of Fusarium spp. in grain foods and the involvement of the gastrointestinal tract in some cases raise the possibility, though unlikely, of a gastrointestinal route of infection (7,119). Thus far, Fusarium spp.…”

Section: Pathogenesis Of Infectionmentioning

confidence: 99%

Taxonomy, biology, and clinical aspects of Fusarium species

1994

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There are several taxonomic systems available for identifying Fusarium species. The philosophy used in each taxonomic system is discussed as well as problems encountered in working with Fusarium species in culture. Fusarium species are toxigenic, and the mycotoxins produced by these organisms are often associated with animal and human diseases. The implications for the association of the carcinogens, fumonisins, produced by Fusarium moniliforme and other Fusarium species with human diseases are discussed. Foreign-body-associated fusarial infection such as keratitis in contact lens wearers, onychomycosis, skin infections, and disseminated multiorgan infections are discussed. Disseminated fusarial hyalohyphomycosis has emerged as a significant, usually fatal infection in the immunocompromised host. Successful outcome is determined by the degree of immunosuppression, the extent of the infection, and the presence of a removable focus such as an indwelling central venous catheter. These infections may be clinically suspected on the basis of a constellation of clinical and laboratory findings, which should lead to prompt therapy, probably with one of the newer antifungal agents. Perhaps the use of such agents or the use of colony-stimulating factors may improve the outcome of this devastating infection. However, until new approaches for treatment develop, effective preventive measures are urgently needed.

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“…Members of the F. solani and Fusarium oxysporum species complex are ubiquitous in the environment, where they survive as plant pathogens and saprophytes (7), and Fusarium species and other filamentous fungi are an increasing cause of invasive human mycoses in immune-compromised or neutropenic individuals, where they cause systemic fusariosis and endophthalmitis (8 –11). However, the most common manifestation of Fusarium infection is keratitis, which occurs in otherwise healthy individuals engaged in agricultural work (12, 13).…”

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confidence: 99%

MyD88 Regulation of Fusarium Keratitis Is Dependent on TLR4 and IL-1R1 but Not TLR2

Tarabishy

Aldabagh

Sun

et al. 2008

The Journal of Immunology

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The fungal pathogens Fusarium solani and Fusarium oxysporum cause severe corneal disease in the United States and worldwide and were the causative organisms in a recent outbreak of contact lens-associated keratitis. To characterize innate immunity in Fusarium keratitis, we developed a murine model in which conidia are injected into the corneal stroma. Immunocompetent C57BL/6 mice rapidly developed severe corneal opacification associated with neutrophil infiltration and clearance of Fusarium hyphae. In contrast, neutrophil infiltration was delayed in MyD88−/− mice, resulting in uncontrolled growth of Fusarium hyphae in the corneal stroma and anterior chamber, and eventually resulting in corneal perforation. Corneal opacification scores in TLR2−/−, TLR4−/−, and TLR2/4−/− mice were similar to those of C57BL/6 mice; however, TLR4−/− and TLR2/4−/− mice had impaired antifungal responses. The phenotype of infected IL-1R1−/− mice was similar to that of MyD88−/− mice, with uncontrolled fungal growth resulting in corneal perforation. IL-1R1−/− mice also produced significantly less CXCL1/KC in the corneal stroma compared with C57BL/6 mice consistent with delayed neutrophil recruitment to the corneal stroma. Together, these findings indicate that IL-1R1 and MyD88 regulate CXC chemokine production and neutrophil recruitment to the cornea, and that TLR4 has an important role in controlling growth and replication of these pathogenic fungi.

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Primary disseminated fusarial infection

Cited by 26 publications

References 16 publications

Fusarium Infections in Immunocompromised Patients

Fusarium Infections in Immunocompromised Patients

Taxonomy, biology, and clinical aspects of Fusarium species

MyD88 Regulation of Fusarium Keratitis Is Dependent on TLR4 and IL-1R1 but Not TLR2

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