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Disseminated Fusariosis Secondary to Neuroblastoma with Fatal Outcome

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Abstract

Disseminated fusariosis is an uncommon clinical condition in immunocompromised patients. We report a fatal case of disseminated fusariosis secondary to neuroblastoma in a male patient, 15 years old, who underwent a bone marrow transplant. The patient was admitted to the pediatric intensive care unit (PICU) of a public hospital in Recife-PE, Brazil, presenting bone marrow aplasia, severe leukopenia, and thrombocytopenia. After 15 days, the patient developed right knee effusion. Synovial fluid and blood samples were analyzed at the Medical Mycology Laboratory of the Federal University of Pernambuco. Mycological diagnosis was based on the presence of hyaline septate hyphae on direct examination and the isolation of Fusarium oxysporum in culture, confirming the case of disseminated fusariosis. In vitro, the isolate showed fluconazole resistance and sensitivity to amphotericin B, anidulafungin, and voriconazole. Therapy with voriconazole in combination with liposomal amphotericin B led to an improved clinical response; however, due to underlying disease complications, the patient progressed to death.

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References

  1. Guarro J, Nucci M, Akiti T, Gene J. Mixed infection caused by two species of Fusarium in a human immunodeficiency virus-positive patient. J Clin Microbiol. 2000;38:3460–2.

    PubMed  CAS  Google Scholar 

  2. Sekhon AS, Padhye AA, Garg AK, Ahmad H, Moledina N. In vitro sensitivity of medically significant Fusarium species to various antimycotics. Chemotherapy. 1994;40:239–44.

    Article  PubMed  CAS  Google Scholar 

  3. Nucci M, Anaissie E. Fusarium infections in immunocompromised patients. Clin Microbiol Rev. 2007;20:695–704.

    Article  PubMed  CAS  Google Scholar 

  4. Karam A, Eveillard JR, Ianoto JC, Quinio D, Le Flohic AM, Le Roy JP. Disseminated cutaneous and visceral fusariosis in an aplastic patient: an unusual digestive entry. An Dermatol Venereol. 2005;8:132–55.

    Google Scholar 

  5. Leslie JF, Summerell BA. The Fusarium laboratory manual. Sydney: Blackwell Publishing; 2006.

    Google Scholar 

  6. Clinical and Laboratory Standards Institute Reference method for broth dilution antifungal susceptibility testing of filamentous fungi approved standard. In: Clinical and laboratory standards institute; Wayne, PA: 2nd ed. CLSI document M38-A2; 2008.

  7. Even C, Bastuji-Garin S, Hicheri Y, Pautas C, Botterel F, Maury S, Cabanne L, Bretagne S, Cordonnier C. Impact of invasive fungal disease on the chemotherapy schedule and event-free survival in acute leukemia patients who survived fungal disease: a case control study. Haematol. 2011;96:337–41.

    Article  Google Scholar 

  8. Martino R, Kerguelen A, Valcarcel D. Reduction of infection related mortality after allogeneic PBSCT from HLA-identical siblings: longitudinal analysis from 1994 to 2008 at a single institution. Bone Marrow Transplant. 2011;46:690–701.

    Article  PubMed  CAS  Google Scholar 

  9. Matthay KK, Perez C, Seeger RC, Brodeur GM, Shimada H, Atkinson JB, Black CT, Gerbing R, Haase GM, Stram DO, Swift P, Lukens JN. Successful treatment of stage III neuroblastoma based on prospective biologic staging: a children’s cancer group study. J Clin Oncol. 1998;16:1256–64.

    PubMed  CAS  Google Scholar 

  10. Evans AE, D’Angio GJ, Randolph J. A proposed staging for children with neuroblastoma a children’s cancer study group. Cancer. 1971;2:374–8.

    Article  Google Scholar 

  11. Paya E, Zubieta M, Dias C, Piontelli E. Fusarium oxysporum fungemia related to central venous catheter in a children with cancer. Rev Child Inf. 2000;17:34–8.

    Google Scholar 

  12. O’Donnell K, Sutton DA, Rinaldi MG, Magnon KC, Cox PA, Revankar SG, Sanche S, Geiser DM, Juba JH, van Burik JA, Padhye A, Anaissie EJ, Francesconi A, Walsh TJ, Robinson JS. Genetic diversity of human pathogenic members of the Fusarium oxysporum complex inferred from multi locus DNA sequence data and amplified fragment length polymorphism analyses: evidence for the recent dispersion of a geographically widespread clonal lineage and nosocomial origin. J Clin Microbiol. 2004;42:5109–20.

    Article  PubMed  Google Scholar 

  13. Joly ID, Alfandari S, Benchikh ZD, Rodrigue M, Ingroff AE, Catteau B, Cordevant C, Camus D, Dei-Cas E, Bauters F, Delhaes L. Successful outcome of disseminated Fusarium infection with skin localization treated with voriconazole and amphotericin B-lipid complex in a patient with acute leukemia. J Clin Microbiol. 2003;41:4898–900.

    Article  Google Scholar 

  14. Rothe A, Seibold M, Hoppe TH, Seifert H, Engert A, Caspar C, Karthaus M, Kenheuer GF, Bethe U, Tintelnot K, Cornely OA. Combination therapy of disseminated Fusarium oxysporum infection with terbinafine and amphotericin B. Ann Hematol. 2004;83:394–7.

    Article  PubMed  CAS  Google Scholar 

  15. Gianni C, Cerri A, Crosti C. Unusual clinical features of fingernail infection by Fusarium oxysporum. Mycoses. 1997;40:455–9.

    Article  PubMed  CAS  Google Scholar 

  16. Romano C, Caposciutti P, Ghilardi A, Miracco C, Fimiani M. A case of primary localized cutaneous infection due to Fusarium oxysporum. Mycopathologia. 2010;170:39–46.

    Article  PubMed  CAS  Google Scholar 

  17. Consigny S, Dhedin N, Datry A, Choquet S, Leblond V, Chosidow O. Successful voriconazole treatment of disseminated Fusarium infection in an immunocompromised patient. Clin Infect Dis. 2003;37:311–3.

    Article  PubMed  Google Scholar 

  18. Guarro J, Gene J. Opportunistic fusarial infections in humans. Eur J Clin Microbiol Infect Dis. 1995;14:741–54.

    Article  PubMed  CAS  Google Scholar 

  19. Speeleveld E, Gordts B, Van Landuyt HW, De Vroey C, Raes- Wuytack C. Susceptibility of clinical isolates of Fusarium to antifungal drugs. Mycoses. 1996;39:37–40.

    Article  PubMed  CAS  Google Scholar 

  20. Boutati EI, Anaissie EJ. Fusarium, a significant emerging pathogen in patients with hematologic malignancy: ten years’ experience at a cancer center and implications for management. Blood. 1997;90:999–1008.

    PubMed  CAS  Google Scholar 

  21. Pincelli TPH, Brandt HRC, Motta AL, Maciel FVR, Criado PR. Fusariosis in an immunocompromised patient: therapeutic success with voriconazole. An Bras Dermatol. 2008;83:331–4.

    Article  Google Scholar 

  22. Boutati EI, Anaissie EJ. Fusarium, a significant emerging pathogen in patients with hematologic malignancy: ten years’ experience at a cancer center and implications for management. Blood. 1997;90:999–1008.

    PubMed  CAS  Google Scholar 

  23. Anaissie EJ, Kuchar RT, Rex JH, Francesconi A, Kasai M, Muller FMC, Lozano-Chiu M, Summerbell RC, Dignani MC, Chanock SJ, Walsh TJ. Fusariosis associated with pathogenic Fusarium species colonization of a hospital water system: a new paradigm for the epidemiology of opportunistic mold infections. Clin Infect Dis. 2001;33:1871–8.

    Article  PubMed  CAS  Google Scholar 

  24. Walsh TJ, Groll AH. Emerging fungal pathogens: evolving challenges to immunocompromised patients for the twenty-first century. Transpl Infect Dis. 1999;1:247–61.

    Article  PubMed  CAS  Google Scholar 

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Acknowledgments

The authors are grateful to the Medical Mycology Laboratory team of Universidade Federal de Pernambuco, to the doctors, for the credibility and trust, and to Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) for financing the research.

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Authors and Affiliations

  1. Departamento de Micologia, Universidade Federal de Pernambuco, Av. Prof Nelson Chaves, s/nº, Cidade Universitária, Recife, PE, 50670-420, Brazil

    Gleiciere Maia Silva, Alice Rangel Cristiane Silveira, Danielle Patrícia Cerqueira Macêdo & Rejane Pereira Neves

  2. Hospital Oswaldo Cruz. R. Arnóbio Marques, 310, Santo Amaro, Recife, PE, 50100-130, Brazil

    Claudia Abreu Rodrigues Betânia

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  1. Gleiciere Maia Silva
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  2. Alice Rangel Cristiane Silveira
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  3. Claudia Abreu Rodrigues Betânia
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  4. Danielle Patrícia Cerqueira Macêdo
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  5. Rejane Pereira Neves
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Correspondence to Rejane Pereira Neves.

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Silva, G.M., Silveira, A.R.C., Betânia, C.A.R. et al. Disseminated Fusariosis Secondary to Neuroblastoma with Fatal Outcome. Mycopathologia 176, 233–236 (2013). https://doi.org/10.1007/s11046-013-9674-8

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