Superficial skin lesions positive for Fusarium are associated with subsequent development of invasive fusariosis
- PMID: 23994063
- DOI: 10.1016/j.jinf.2013.08.011
Superficial skin lesions positive for Fusarium are associated with subsequent development of invasive fusariosis
Abstract
Objectives: To evaluate the frequency of skin colonization by Fusarium spp. in high-risk hematologic patients and its impact on the subsequent development of invasive fusariosis.
Methods: We screened all high-risk hematologic patients from August 2008 to December 2009 with cultures of 6 pre-defined areas in the feet and hands on admission and at discharge. In addition, cultures of any skin lesion present on admission were performed.
Results: Among 61 patients screened, alterations in the skin and/or nails were present in 32 patients (52%) on admission, mostly represented by abnormal appearing nails and intertrigo. Four patients (7.2%) presented positive baseline cultures for Fusarium spp., all in existing lesions of onychomycosis, intertrigo or both. Invasive fusariosis was diagnosed in six patients. The presence of a skin lesion at baseline that grew Fusarium spp. was associated with the subsequent development of invasive fusariosis (p = 0.04).
Conclusions: Our data suggest that: 1) baseline cultures in patients without alterations in the skin and/or nails seems not justifiable; 2) cultures of pre-existing lesions may help to identify a group of patients at higher risk to develop invasive fusariosis. The use of anti-mould prophylaxis in this setting should be explored in future studies.
Keywords: Fusariosis; Hematologic disease; Invasive fungal disease; Onychomycosis; Risk factor.
Copyright © 2013 The British Infection Association. Published by Elsevier Ltd. All rights reserved.
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