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Disseminated Fusarium infections in patients following bone marrow transplantation
R L Minor1, M A Pfaller, R D Gingrich
1Department of Medicine, University of Iowa College of Medicine, Iowa City 52247.
Abstract:
Intensive immunosuppressive therapy and broad spectrum antibiotics predispose cancer patients to opportunistic fungal infections. Fusarium has rarely been reported as a pathogen in immunocompromised patients, but is almost uniformly fatal. Only six cases of disseminated Fusarium infection have been described in patients following bone marrow transplantation (BMT). We report here two additional cases. Fusarium infection initially presented with pyomyositis in one patient and with embolic skin lesions in another following T cell-depleted BMT. Both patients died with active Fusarium infection despite an extensive course of amphotericin B, rifampicin and granulocyte transfusions. From this experience and from a review of the literature, Fusarium infections appear to be increasing in prevalence as significant pathogens in immunocompromised hosts and are resistant to many conventional forms of therapy.
Insights
Fusarium fungal infections are rare but fatal in immunocompromised patients, particularly after bone marrow transplantation (BMT). These infections are increasingly prevalent and resistant to standard therapies.
Area of Science:
- Mycology
- Infectious Diseases
- Hematology
Background:
- Intensive immunosuppressive therapy and broad-spectrum antibiotics increase the risk of opportunistic fungal infections in cancer patients.
- Fusarium species are rarely reported as pathogens in immunocompromised individuals, but infections are almost uniformly fatal.
- Disseminated Fusarium infection following bone marrow transplantation (BMT) is exceptionally uncommon, with only six prior cases described.