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Diagnosis and Treatment of Foot Fusarium Infection Confirmed by Molecular Identification: A Case Report and
Yulin Wang1,2,3,4, Danyue He1,2,3,4, Jie Hu1,2,3,4
1Department of Dermatology, the First Affiliated Hospital Anhui Medical University Hefei Anhui China.
Abstract:
Fusarium spp. are opportunistic fungal pathogens, with an increasing incidence of infection observed in immunocompromised populations. Due to the non-specific clinical manifestations of cutaneous Fusarium infections, they are often misdiagnosed or overlooked. This article reports an 84-year-old man with a chronic post-traumatic foot lesion in whom histopathology was non-diagnostic, while the definitive diagnosis of Fusarium solani species complex (FSSC) was established by positive fungal culture from deep tissue biopsy followed by 18S rDNA/ITS sequencing. The patient's condition improved following individualized antifungal therapy. Combined with a literature review, we discuss the clinical characteristics, diagnostic and therapeutic strategies, and treatment challenges associated with FSSC skin infections. This case underscores the limitations of traditional fungal culture and highlights the necessity of molecular methods, such as 18S rDNA and Internal Transcribed Spacer (ITS) sequencing, for early and accurate diagnosis. Treatment should be guided by antifungal susceptibility testing and host immune status, with particular attention to the intrinsic resistance patterns of Fusarium species.
Insights
Accurate diagnosis of Fusarium solani species complex (FSSC) skin infections in immunocompromised patients is crucial. Molecular methods like 18S rDNA/ITS sequencing are vital for early detection, improving patient outcomes.
Area of Science:
- Mycology
- Infectious Diseases
- Dermatology
Background:
- Fusarium spp. are opportunistic fungal pathogens causing infections, particularly in immunocompromised individuals.
- Cutaneous Fusarium infections often present with non-specific symptoms, leading to misdiagnosis or delayed treatment.
- The incidence of Fusarium infections is rising in vulnerable patient populations.
Purpose of the Study:
- To report a case of Fusarium solani species complex (FSSC) skin infection in an elderly patient with a chronic foot lesion.
- To highlight the diagnostic challenges and limitations of conventional methods in identifying FSSC.
- To emphasize the importance of molecular techniques and individualized antifungal therapy for FSSC infections.
Main Methods:
- Case report of an 84-year-old male with a chronic post-traumatic foot lesion.
- Histopathology and fungal culture from deep tissue biopsy.
- Definitive diagnosis using 18S rDNA and Internal Transcribed Spacer (ITS) sequencing.
- Literature review on FSSC skin infections.
Main Results:
- Histopathology was non-diagnostic, but fungal culture confirmed FSSC.
- Molecular sequencing (18S rDNA/ITS) provided definitive identification of FSSC.
- The patient improved with individualized antifungal therapy guided by susceptibility testing.
- Literature review provided insights into clinical characteristics and treatment strategies.
Conclusions:
- Molecular methods (18S rDNA/ITS sequencing) are essential for accurate and early diagnosis of FSSC skin infections.
- Traditional fungal culture has limitations in diagnosing these infections.
- Treatment requires antifungal susceptibility testing and consideration of host immune status and Fusarium resistance patterns.
- Prompt and accurate diagnosis is critical for effective management of FSSC infections.
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