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Fungaemia due to Fusarium spp. in cancer patients
V Krcmery1, Z Jesenska, S Spanik
1Department of Microbiology, Medicine, Chemotherapy and Haematology, National Cancer Institute, Bratislava, Slovak Republic.
Abstract:
Five cases of fungaemia due to Fusarium spp. in cancer patients are described. Two were breakthrough cases, despite ongoing therapy with amphotericin B. Three were caused by Fusarium solani, one by F. oxysporum and one by F. dimerum. Four patients died, three of them despite therapy with amphotericin B for between 5-37 days. We describe only the second reported case of F. dimerum fungaemia. Since 1972, 93 cases of systemic infection with Fusarium spp. have been described: 43 had positive blood cultures and the overall mortality was 72%.
Insights
Fusarium fungaemia is a serious threat to cancer patients, often resistant to amphotericin B. This study highlights the high mortality rate of Fusarium infections in this vulnerable population.
Area of Science:
- Mycology
- Infectious Diseases
- Oncology
Background:
- Fusarium species are increasingly recognized as opportunistic pathogens, particularly in immunocompromised individuals.
- Cancer patients undergoing chemotherapy or with hematologic malignancies are at high risk for invasive fungal infections.
- Systemic infections caused by Fusarium species, known as fungaemia, carry a significant mortality burden.
Observation:
- This report details five cases of fungaemia caused by Fusarium species in cancer patients.
- Two cases were considered breakthrough infections, occurring despite active treatment with amphotericin B.
- The causative species included Fusarium solani, Fusarium oxysporum, and Fusarium dimerum, with F. dimerum being exceptionally rare.
Findings:
- Four out of five patients succumbed to their infections.
- Three patients died despite receiving amphotericin B therapy for extended periods (5-37 days).
- The overall reported mortality for Fusarium spp. systemic infections since 1972 is 72%.
Implications:
- The findings underscore the challenges in treating Fusarium fungaemia in cancer patients.
- Current antifungal therapies, including amphotericin B, may have limited efficacy against these infections.
- Further research into novel therapeutic strategies is crucial for improving outcomes in this high-risk patient group.