Antifungal Agents/therapeutic use* ; Child ; Fusariosis/drug therapy* ; Humans ; Leukemia, Myeloid, Acute/drug therapy*

Fusarium species are common soil saprophytes and plant pathogens. In humans, several species have been recognized as agents of superficial infections. Disseminated Fusariosis have been increasingly described in immunocompromised patients, especially in neutropenic patients. The prognosis is very poor despites antifungal therapy. This is the report of Fusarium oxysporum infection in a 6-year-old patient with relapsed acute leukemia and prolonged neutropenia. The patient presented with persistent fever and multiple erythematous papules with central necrosis or vesicle. Fuasrium oxysporum was isolated and cultured from a skin biopsy specimen. Initially, the patient failed to respond to conventional amphotericin B but recovered after treatment was switched to liposomal amphotericin B and voriconazole.
Amphotericin B* ; Biopsy ; Child* ; Drug Therapy* ; Fever ; Fusariosis* ; Fusarium ; Humans ; Immunocompromised Host ; Leukemia ; Necrosis ; Neutropenia ; Plants ; Prognosis ; Skin ; Soil

A healthy 27-year-old woman with a corneal ulcer underwent fibrin gluing with a bandage contact lens twice, due to an impending perforation. The ulcer lesion slowly progressed, unresponsive to topical antibiotics and amphotericin B. We removed the gluing patch and performed a corneal or scraping or biopsy with multiple amniotic membrane grafts to seal the thinned or perforated cornea. Three days after the surgery, the corneal cultures grew Fusarium, as well as Enterococcus faecalis. Three weeks after surgery, the outermost layer of amniotic membranes, serving as a temporary patch, was removed. The anterior chamber was clear without cells. The signs of infection clinically and symptomatically cleared up four weeks later. Two months after surgery, the lesion became enhanced by amniotic membranes. The use of fibrin glue in infectious keratitis should be avoided, because it not only masks the underlying lesion, but it also interferes with drug penetration into the underlying lesion.
Adult ; Corneal Perforation/*drug therapy ; Corneal Ulcer/*drug therapy/*microbiology ; Eye Infections, Fungal/*microbiology ; Female ; Fibrin Tissue Adhesive/*therapeutic use ; Fusariosis/*microbiology ; Fusarium/*isolation & purification ; Humans

Recently, we experienced a case of disseminated fusarial blood stream infection with varicelloid skin eruptions, who had suffered from persistent neutropenic fever after salvage chemotherapy for relapsed acute lymphocytic leukemia (ALL). Neutropenia continued in spite of G-CSF and granulocyte transfusion, and he failed to respond to conventional amphotericin B initially, and then liposomal amphotericin B and voriconazole combination therapy. Disseminated fusariosis can be diagnosed by blood cultures in 50% of patients and present skin lesions in more than 80% of patients. So, typical skin lesions are important clue to diagnose of the disseminated fusariosis. However, many skin lesions in immunocompromised hosts are due to various infectious and non-infectious causes. So, this case shows that it is important to obtain biopsy specimens of skin lesions for histopathologic examination, culture and staining. Here, we present our case with the review of the literatures reported in our country, so far.
Amphotericin B ; Biopsy ; Chickenpox* ; Drug Therapy ; Fever ; Fusariosis* ; Fusarium* ; Granulocyte Colony-Stimulating Factor ; Granulocytes ; Humans ; Immunocompromised Host ; Leukemia* ; Neutropenia ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Rivers ; Skin*

Recently, we experienced a case of disseminated fusarial blood stream infection with varicelloid skin eruptions, who had suffered from persistent neutropenic fever after salvage chemotherapy for relapsed acute lymphocytic leukemia (ALL). Neutropenia continued in spite of G-CSF and granulocyte transfusion, and he failed to respond to conventional amphotericin B initially, and then liposomal amphotericin B and voriconazole combination therapy. Disseminated fusariosis can be diagnosed by blood cultures in 50% of patients and present skin lesions in more than 80% of patients. So, typical skin lesions are important clue to diagnose of the disseminated fusariosis. However, many skin lesions in immunocompromised hosts are due to various infectious and non-infectious causes. So, this case shows that it is important to obtain biopsy specimens of skin lesions for histopathologic examination, culture and staining. Here, we present our case with the review of the literatures reported in our country, so far.
Amphotericin B ; Biopsy ; Chickenpox* ; Drug Therapy ; Fever ; Fusariosis* ; Fusarium* ; Granulocyte Colony-Stimulating Factor ; Granulocytes ; Humans ; Immunocompromised Host ; Leukemia* ; Neutropenia ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Rivers ; Skin*