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Published on: October 7, 2012
Fusariosis
Fabio Nucci1, Simone A Nouér2, Domenico Capone2
1Hematology Service, University Hospital, Universidade Federal Fluminense, Niteroi, Brazil.
Abstract:
Fusarium species are frequent agents of onychomycosis and fungal keratitis, and occasional agents of invasive disease. The clinical spectrum of fusariosis in the lungs includes allergic disease (allergic bronchopulmonary fusariosis), hypersensitivity pneumonitis, colonization of a preexisting cavity, and pneumonia. Fusarial pneumonia occurs almost exclusively in severely immunocompromised patients, especially acute leukemia patients and recipients of allogeneic cell transplantation. In such patients, invasive fusariosis is usually disseminated, and pneumonia occurs in almost 50% of cases. The radiologic picture is similar to invasive aspergillosis, with alveolar infiltrates, nodules with or without halo sign, ground-glass infiltrates, and pleural effusions. Different from aspergillosis is the frequent occurrence of disseminated nodular and papular skin lesions and positive blood cultures. The drug of choice for the treatment of invasive fusariosis is either voriconazole or liposomal amphotericin B. The outcome is usually poor, and largely dependent on the recovery of the immune status of the host, particularly neutropenia.
Insights
Fusarium species cause lung infections, particularly pneumonia in immunocompromised patients. Treatment involves voriconazole or liposomal amphotericin B, with outcomes depending on immune recovery.
Area of Science:
- Mycology
- Infectious Diseases
- Pulmonology
Background:
- Fusarium species are common causes of superficial fungal infections like onychomycosis and keratitis.
- They can also cause invasive diseases, including pulmonary infections (fusariosis).
Purpose of the Study:
- To describe the clinical spectrum, radiologic findings, and treatment outcomes of pulmonary fusariosis.
- To differentiate fusariosis from invasive aspergillosis in immunocompromised hosts.
Main Methods:
- Review of clinical cases and radiologic findings of patients with pulmonary fusariosis.
- Analysis of treatment regimens and patient outcomes.
Main Results:
- Fusarial pneumonia predominantly affects severely immunocompromised individuals, especially those with acute leukemia or undergoing stem cell transplantation.
- Radiologic findings mimic invasive aspergillosis but are often accompanied by disseminated skin lesions and positive blood cultures.
- Voriconazole or liposomal amphotericin B are primary treatments, but outcomes are generally poor, linked to immune reconstitution.
Conclusions:
- Pulmonary fusariosis is a severe infection in immunocompromised patients with a high mortality rate.
- Early diagnosis and appropriate antifungal therapy are crucial, but host immune status recovery is paramount for survival.
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