[A man with neutropenic fever]

Area of Science:

• Medical Mycology
• Hematology
• Infectious Diseases

Background:

• Acute myeloid leukemia (AML) is a hematologic malignancy often treated with intensive chemotherapy.
• High-dose cytarabine is a common chemotherapeutic agent used in AML treatment.
• Neutropenia, a common side effect of chemotherapy, increases susceptibility to opportunistic infections.

Observation:

• A 43-year-old patient with relapsed AML developed neutropenic fever following high-dose cytarabine therapy.
• Multiple cutaneous nodules emerged during the neutropenic period.
• Skin biopsy revealed a fungal infection, with Fusarium solani identified by culture.

Findings:

• Fusarium solani, an opportunistic mold, caused a disseminated cutaneous infection in an immunocompromised AML patient.
• The infection occurred in the context of neutropenia induced by high-dose cytarabine chemotherapy.
• Despite the initiation of antimycotic therapy, the fungal infection was refractory.

Implications:

• This case highlights the risk of invasive Fusarium infections in immunocompromised patients, particularly those undergoing intensive chemotherapy for hematologic malignancies.
• Early recognition and aggressive management of fungal infections are crucial in neutropenic patients.
• The management of opportunistic infections in the setting of AML treatment requires a multidisciplinary approach.