Résumé
Abstract: Fusariosis is due to inhalation or direct contact with conidia. Clinical presentation depends on host's immunity and can be localized, focally invasive or disseminated. Given the severity of this infection and the possibility for the dermatologist to make an early diagnosis, we report six cases of patients with hematologic malignancies, who developed febrile neutropenia an skin lesions suggestive of cutaneous fusariosis. All patients had skin cultures showing growth of Fusarium solani complex, and they received amphotericin B and voriconazole. As this infection can quickly lead to death, dermatologists play a crucial role in diagnosing this disease.
Sujets)
Humains , Adulte d'âge moyen , Jeune adulte , Peau/microbiologie , Leucémie aigüe myélomonocytaire/complications , Leucémie-lymphome lymphoblastique à précurseurs B/complications , Fusariose/complications , Fusarium/isolement et purification , Myélome multiple/complications , Antifongiques/usage thérapeutique , Peau/anatomopathologie , Issue fatale , Fusariose/anatomopathologie , Fusariose/prévention et contrôle , Neutropénie/étiologieRésumé
Resumen Presentamos el caso clínico de un paciente con una leucemia linfoblástica aguda (LLA) que desarrolló una fusariosis diseminada por Fusarium verticillioides durante un episodio prolongado de neutropenia febril post quimioterapia. Fue exitosamente tratado cuando se usó terapia combinada de voriconazol más anfotericina B deoxicolato.
We report a case of a patient with acute lymphoblastic leukemia (ALL), who developed a disseminated infection by Fusarium verticillioides during chemotherapy-induced neutropenia. He was successfully treated only after combination therapy with voriconazole plus amphotericin B deoxycolate was used, but not when these compounds were used in an isolated form.
Sujets)
Humains , Mâle , Adolescent , Amphotéricine B/usage thérapeutique , Acide désoxycholique/usage thérapeutique , Fusariose/traitement médicamenteux , Voriconazole/usage thérapeutique , Antifongiques/usage thérapeutique , Neutropénie/traitement médicamenteux , Leucémie-lymphome lymphoblastique à précurseurs B/complications , Leucémie-lymphome lymphoblastique à précurseurs B/microbiologie , Leucémie-lymphome lymphoblastique à précurseurs B/traitement médicamenteux , Association médicamenteuse , Association de médicaments , Fusariose/étiologie , Fusariose/anatomopathologie , Neutropénie/étiologie , Neutropénie/anatomopathologieRésumé
Disseminated infection by Fusarium is a rare, frequently lethal condition in severely immunocompromised patients, including bone marrow transplant recipients. However, autologous bone marrow transplant recipients are not expected to be at high risk to develop fusariosis. We report a rare case of lethal disseminated Fusarium infection in an autologous bone marrow transplant recipient during pre-engraftment phase.