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. 2023 Aug 23:42:100602.
doi: 10.1016/j.mmcr.2023.08.005. eCollection 2023 Dec.

Fusariosis in patients with hematological malignancies: Two case reports

Jord W Raymakers  1 , Daan A R Castelijn  2 , Caroline E Rutten  2 , Caspar J Hodiamont  1
Affiliations

Fusariosis in patients with hematological malignancies: Two case reports

Jord W Raymakers et al. Med Mycol Case Rep. .

Abstract

Immunosuppressed patients with hematological malignancies are at risk for invasive fungal infections (IFI), including infections with Fusarium species (spp.), which are increasingly reported. Particularly at risk are patients with acute myeloid leukemia (AML) treated with high-dose cytarabine as remission-induction therapy. Whether cytarabine increases the risk of IFI in comparison to other chemotherapy remains not fully determined. Additionally, no clear correlation between the in vitro established minimal inhibitory concentrations (MICs) of antifungal agents and clinical outcome has been established for fusariosis. To increase awareness and knowledge of invasive fusariosis, we report two cases of Fusarium spp. infections in neutropenic patients following treatment with cytarabine for AML. Despite high MICs for azoles both patients were treated with an azole in combination with liposomal amphotericin B. The combination therapy was successful in one patient, however the other patient did not survive the disseminated Fusarium infection.

Keywords: Combination therapy; Cytarabine; Fusariosis; Fusarium species; Hematological malignancies.

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Conflict of interest statement

All authors declare no conflict of interest.

Figures

Fig. 1
Fig. 1
Picture of skin lesions.
Fig. 2
Fig. 2
Axial plane of PET-CT with increased FDG uptake of the middle of the left hand.
Fig. 3
Fig. 3
Picture of the necrotic lesion of the left middle finger.
Fig. 4
Fig. 4
Picture of a necrotic lesion on the left lower arm.
Fig. 5
Fig. 5
Image of a periodic acid-Schiff (PAS) stained histological skin biopsy with hyphae visible in black circles.
See this image and copyright information in PMC

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