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Fusarium infections in immunocompromised patients: Case reports and literature review

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Abstract

Five cases are reported ofFusarium infection in patients with aplasia following chemotherapy of leukemia. The clinical signs, diagnosis and course of the infection during treatment are outlined and discussed in conjunction with the characteristics of other cases already reported in the literature. Sixty-three cases ofFusarium infection have been reported in immunocompromised patients, 44 cases since 1985. These included patients with hematological malignancies (58 cases), especially acute leukemia (43 cases). The main sites of infection were the skin (46 cases), blood (28 cases) and lungs (13 cases). The infection was mostly diagnosed by means of skin biopsy but also by means of positive blood cultures. Forty-three strains were identified, 19 of which wereFusarium solani. Amphotericin B treatment was given in 55 cases, often combined with other antifungal agents, leukocyte transfusions or granulocyte-macrophage-colony stimulating factor. The outcome was fatal in 36 of the 63 cases reported, often due to resistance of the strain to antifungal agents, particularly amphotericin B (20 of 33 strains tested). The most important risk factor seems to be profound and prolonged aplasia. Deep mycoses due toFusarium species thus pose an important problem and are occurring in increasing numbers in immunocompromised patients. Treatment of these infections is difficult and the prognosis is poor.

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Authors and Affiliations

  1. Département de Parasitologie et de Mycologie, Université Claude-Bernard Lyon I, 8 Avenue Rockefeller, 69373, Lyon Cedex 08, France

    M. Rabodonirina, M. A. Piens, M. F. Monier & M. Mojon

  2. Unité de Mycologie, Institut Pasteur, 28 Rue du Docteur Roux, 75724, Paris Cedex 15, France

    E. Guého

  3. Service d'Hématologie, Hôpital Edouard-Herriot, Place d'Arsonval, 69437, Lyon Cedex 03, France

    D. Fière

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  1. M. Rabodonirina
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Rabodonirina, M., Piens, M.A., Monier, M.F. et al. Fusarium infections in immunocompromised patients: Case reports and literature review. Eur. J. Clin. Microbiol. Infect. Dis. 13, 152–161 (1994). https://doi.org/10.1007/BF01982190

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