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Fatal disseminated infection with Fusarium petroliphilum

Tuba Ersal1, Abdullah S M Al-Hatmi, Burcu Dalyan Cilo

  • 1Department of Haematology, Faculty of Medicine, Uludağ University, Bursa, Turkey.

Mycopathologia
|September 20, 2014
PubMed

Insights

A rare Fusarium strain caused a fatal infection in a leukemia patient. This Fusarium petroliphilum strain showed unusual morphology and responded best to amphotericin B, not azoles or echinocandins.

Area of Science:

  • Medical Mycology
  • Clinical Microbiology

Background:

  • Fusarium solani species complex (FSSC) infections, known as fusariosis, are a significant cause of mortality, particularly in immunocompromised individuals like leukemia patients.
  • Disseminated fusariosis presents a high mortality rate, with leukemia patients being the most susceptible demographic.

Observation:

  • A case of fatal fusariosis in a patient with acute lymphatic leukemia is presented.
  • The etiological agent was identified as a degenerated-morphology strain of Fusarium petroliphilum, a recently recognized FSSC member.
  • Initial fungal cultures exhibited atypical morphology, resembling Fusarium/Acremonium, with conidiospore production directly on hyphae, later reverting to typical FSSC morphology.

Findings:

  • Multi-locus sequence typing confirmed the identification of Fusarium petroliphilum.
  • Histopathological examination of biopsy samples revealed septate hyphae, characteristic of fungal infection.
  • Antifungal susceptibility testing demonstrated that amphotericin B was the most effective treatment, outperforming azoles and echinocandins for this FSSC isolate.

Implications:

  • This case highlights the potential for unusual morphological presentations of FSSC infections.
  • Accurate identification and susceptibility testing are crucial for effective treatment of fusariosis in immunocompromised patients.
  • Amphotericin B should be considered a primary therapeutic option for infections caused by this FSSC member.

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