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Invasive Acremonium strictum infection in a bone marrow transplant recipient

Spiros Miyakis1, Aristea Velegraki, Sophia Delikou

  • 1Third Department of Medicine, University of Athens, Sotiria General Hospital, Greece. miyakis@hotmail.com

The Pediatric Infectious Disease Journal
|March 3, 2006
PubMed

Insights

A rare Acremonium strictum fungal infection in a bone marrow transplant patient was successfully treated, even with amphotericin B resistance. This case adds to the limited data on invasive Acremonium infections in children.

Area of Science:

  • Mycology
  • Infectious Diseases
  • Pediatric Hematology/Oncology

Background:

  • Invasive fungal infections pose a significant risk to immunocompromised patients, particularly pediatric bone marrow transplant (BMT) recipients.
  • Acremonium species are increasingly recognized as opportunistic pathogens, though invasive infections remain uncommon.

Observation:

  • A 9-year-old pediatric BMT recipient presented with a severe, invasive Acremonium strictum infection.
  • The infection manifested with positive bone and urine cultures for A. strictum.
  • Initial treatment with amphotericin B was ineffective due to fungal resistance.

Findings:

  • Successful treatment of invasive A. strictum infection was achieved despite amphotericin B resistance.
  • This case contributes to the understanding of Acremonium infections in pediatric hosts.
  • A review of English literature identified 15 cases of opportunistic invasive Acremonium infections in pediatric patients.

Implications:

  • Highlights the potential for Acremonium species to cause invasive disease in immunocompromised children.
  • Underscores the importance of considering fungal pathogens beyond common culprits in BMT recipients.
  • Suggests the need for susceptibility testing and alternative antifungal agents when initial therapy fails.

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