Successful treatment of disseminated Fusarium infection in an immunocompromised child

Am J Pediatr Hematol Oncol. 1990 Fall;12(3):319-24. doi: 10.1097/00043426-199023000-00013.

Abstract

We report the first know case of disseminated fungal infection due to Fusarium proliferatum in a bone marrow transplant recipient to our knowledge. Fusarium was cultured from the blood, a paranasal sinus, and necrotic skin lesions. The isolate was sensitive to amphotericin B and on further sensitivity testing, synergy was demonstrated using rifampin in combination with amphotericin B. The patient had this infection while she was receiving alternate-day amphotericin, rifampin, and 5-flucytosine (5-FC) therapy. The infection was documented within 48 h of discontinuing daily granulocyte transfusions, which she had received for 3 weeks. The 5-FC was discontinued when sensitivities showed the organism resistant. After 6 weeks of treatment she showed complete remission of the infection, although neutrophil counts remained below 0.25 X 10(9)/L. From this case and from a review of the literature, it appears that synergic antifungal agents combined with leukocyte transfusions may be beneficial in the successful treatment of fusariosis in the compromised host.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Amphotericin B / administration & dosage
  • Amphotericin B / therapeutic use*
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Aspergillosis / complications
  • Bone Marrow Transplantation / adverse effects
  • Child, Preschool
  • Combined Modality Therapy
  • Female
  • Fusarium* / isolation & purification
  • Humans
  • Mycoses / drug therapy*
  • Mycoses / etiology
  • Neutropenia / complications
  • Opportunistic Infections / drug therapy*
  • Opportunistic Infections / etiology
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / complications
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / immunology
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / therapy
  • Rifampin / therapeutic use*
  • Skin / microbiology
  • Spider Bites / complications
  • Staphylococcal Infections / complications

Substances

  • Amphotericin B
  • Rifampin