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Disseminated infection by Fusarium solani in acute lymphocytic leukemia: A case report
Yu-Fang Yao1, Jia Feng2, Jie Liu1
1Department of Dermatology & Venereology, Peking University Shenzhen Hospital, Shenzhen 518036, Guangdong Province, China.
Background:
In recent years, the rate of immunosuppressed patients has increased rapidly. Invasive fungal infections usually occur in these patients, especially those who have had hematological malignances and received chemotherapy. Fusariosis is a rare pathogenic fungus, it can lead to severely invasive Fusarium infections. Along with the increased rate of immune compromised patients, the incidence of invasive Fusarium infections has also increased from the past few years. Early diagnosis and therapy are important to prevent further development to a more aggressive or disseminated infection.
Case Summary:
We report a case of a 19-year-old male acute B-lymphocytic leukemia patient with fungal infection in the skin, eyeball, and knee joint during the course of chemotherapy. We performed skin biopsy, microbial cultivation, and molecular biological identification, and the pathogenic fungus was finally confirmed to be Fusarium solani. The patient was treated with oral 200 mg voriconazole twice daily intravenous administration of 100 mg liposomal amphotericin B once daily, and surgical debridement. Granulocyte colony-stimulating factor was administered to expedite neutrophil recovery. The disseminated Fusarium solani infection eventually resolved, and there was no recurrence at the 3 mo follow-up.
Conclusion:
Our case illustrates the early detection and successful intervention of a systemic invasive Fusarium infection. These are important to prevent progression to a more aggressive infection. Disseminate Fusarium infection requires the systemic use of antifungal agents and immunotherapy. Localized infection likely benefits from surgical debridement and the use of topical antifungal agents.
Insights
Invasive Fusarium infections are increasing in immunocompromised patients. Early detection and combined antifungal therapy with immunotherapy successfully treated a disseminated case in a leukemia patient.
Area of Science:
- Medical Mycology
- Infectious Diseases
- Hematology
Background:
- The incidence of invasive fungal infections, particularly Fusarium infections, is rising due to an increase in immunosuppressed patients, especially those with hematological malignancies undergoing chemotherapy.
- Fusarium species are rare but can cause severe, invasive infections in immunocompromised individuals.
Observation:
- A case report details a 19-year-old male with acute B-lymphocytic leukemia who developed disseminated Fusarium infection affecting the skin, eyeball, and knee joint during chemotherapy.
- Diagnostic methods included skin biopsy, microbial cultivation, and molecular identification, confirming Fusarium solani as the causative agent.
Findings:
- The patient received a combination treatment including oral voriconazole, intravenous liposomal amphotericin B, surgical debridement, and granulocyte colony-stimulating factor.
- The disseminated Fusarium solani infection resolved successfully with no recurrence at a 3-month follow-up.
Implications:
- This case highlights the critical importance of early detection and prompt intervention for invasive Fusarium infections to prevent disease progression.
- Successful management of disseminated Fusarium infection necessitates a systemic approach with antifungal agents and immunotherapy, potentially combined with surgical debridement for localized sites.
