Invasive Curvularia Infection in Pediatric Patients With Hematologic Malignancy Identified by Fungal Sequencing

J Pediatric Infect Dis Soc. 2019 Mar 28;8(1):87-91. doi: 10.1093/jpids/piy092.

Abstract

Curvularia is a saprophytic dematiaceous mold and a rare human pathogen. Here, we report three severely immunocompromised pediatric patients who developed invasive Curvularia infection. Diagnosis was achieved or confirmed in all cases by fungal ribosome sequencing, which hastened species identification and targeted treatment for the patients reported. There are no treatment guidelines for invasive Curvularia infection, though we report three patients who were cured of their infection through a combination of surgical resection and various anti-fungal therapies, indicating a relatively low virulence and good prognosis in comparison to other angioinvasive molds.

Keywords: Curvularia; fungal sequencing; leukemia.

Publication types

  • Case Reports

MeSH terms

  • Amphotericin B / therapeutic use
  • Antifungal Agents / therapeutic use
  • Ascomycota / isolation & purification*
  • Child
  • Dermatomycoses / diagnosis*
  • Dermatomycoses / drug therapy
  • Dermatomycoses / immunology*
  • Dermatomycoses / surgery
  • Female
  • Humans
  • Immunocompromised Host*
  • Male
  • Opportunistic Infections / diagnosis
  • Opportunistic Infections / drug therapy
  • Opportunistic Infections / immunology
  • Opportunistic Infections / surgery
  • Precursor B-Cell Lymphoblastic Leukemia-Lymphoma / immunology*
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / immunology*
  • Precursor T-Cell Lymphoblastic Leukemia-Lymphoma / immunology*
  • RNA, Ribosomal, 28S / genetics
  • Sequence Analysis, DNA
  • Voriconazole / therapeutic use

Substances

  • Antifungal Agents
  • RNA, Ribosomal, 28S
  • Amphotericin B
  • Voriconazole