scholarly journals Disseminated fusariosis in a pediatric patient with acute lymphoblastic leukemia and prolonged fever - a case report

2018 ◽  
Vol 71 (9-10) ◽  
pp. 314-318
Author(s):  
Natasa Kacanski ◽  
Branislava Radisic ◽  
Jovanka Kolarovic
Keyword(s):  
Case Report ◽  
Acute Lymphoblastic Leukemia ◽  
Amphotericin B ◽  
Liposomal Amphotericin ◽  
Lymphoblastic Leukemia ◽  
Fusarium Species ◽  
Water System ◽  
Liposomal Amphotericin B ◽  
Fusarium Infection ◽  
Days Of Therapy

Introduction. Infections caused by fungi of Fusarium species occur in immunocompromised individuals as disseminated diseases. Case Report. This case report presents a 5-year-old boy with acute lymphoblastic leukemia who developed a disseminated fusarium infection during reinduction chemotherapy. Fever was the main symptom and it lasted for 15 weeks. Refractory fever despite broad-spectrum antibiotics, as well as nausea, myalgia, pulmonary symptoms with detection of pulmonary infiltrates, liver and spleen involvement indicated an invasive fungal infection. The patient received fluconazole, voriconazole, liposomal amphotericin B and caspofungin. Since high temperature was persistent, diagnostic laparoscopy of the abdomen was done. Scattered lesions, up to 2 mm in diameter, were observed macroscopically on the surface of the liver and spleen. The liver culture was positive for Acinetobacter and Fusarium species. After 38 days of therapy with liposomal amphotericin B and 3 days of ciprofloxacin, the patient became afebrile. Itraconazole (according to the antimycogram) was continued during maintenance therapy. Abdominal ultrasound was completely normal after 5 months of treatment with itraconazole. This boy was our first patient with a disseminated fusarium infection. At that time, Fusarium was detected in the hospital water system and in hospital air samples. Conclusion. A timely diagnosis of invasive fungal diseases in children is a big challenge. Over the past decade, there has been an increase in survival rate of patients with invasive fusariosis due to much more common use of voriconazole or combined antifungal therapy.

Successful treatment of disseminated fusariosis with high dose liposomal amphotericin-B in a patient with acute lymphoblastic leukemia

2005 ◽  
Vol 85 (2) ◽  
pp. 136-138 ◽  
Author(s):  
Laura Cudillo ◽  
Andrea Tendas ◽  
Alessandra Picardi ◽  
Teresa Dentamaro ◽  
Maria Ilaria Del Principe ◽  
...  
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Amphotericin B ◽  
Successful Treatment ◽  
Liposomal Amphotericin ◽  
Lymphoblastic Leukemia ◽  
Liposomal Amphotericin B ◽  
High Dose

#26: Rhino-Orbital Mucormycosis in Immunocompromised Children: Treatment Outcomes of Three Cases

2021 ◽  
Vol 10 (Supplement_1) ◽  
pp. S23-S23
Author(s):  
G Valdés ◽  
M Martínez ◽  
A Morayta
Keyword(s):  
Risk Factors ◽  
Acute Lymphoblastic Leukemia ◽  
Fungal Infection ◽  
Amphotericin B ◽  
Antifungal Therapy ◽  
Early Identification ◽  
Liposomal Amphotericin ◽  
Lymphoblastic Leukemia ◽  
Case Series ◽  
Liposomal Amphotericin B

Abstract Background Mucormycosis is an aggressive opportunistic fungal infection of the family Mucoraceae, including the genera Mucor, Absidia, and Rhizopus. It is the third most common cause of invasive fungal infection, with low incidence, but high mortality (50–90%), and it usually presents in immunocompromised hosts. The fungus spores are ubiquitous in nature and are found in soil, air, and on decaying vegetation. Individuals get infected following inhalation of spores, ingestion, or contamination of wounds. Rhino-orbito-cerebral mucormycosis is the most common form of illness in children. An early diagnosis and a multidisciplinary approach to treatment are necessary to prevent mortality. Methods We present a case series of three immunocompromised children with rhino-orbital mucormycosis in Nacional Medical Center “20 de Noviembre” from 2015 to 2019. We describe time to diagnosis, start of antifungal therapy, surgery involvement, and patient outcomes. Results Patient 1 was a 9-year-old girl with aplastic anemia who developed right palpebral swelling (day 1 of initial symptoms) and was initially diagnosed with preseptal cellulitis. On day 5, a necrotic area appeared in the right inner canthus. Paranasal sinus CT scan showed opacified ethmoidal sinus. Liposomal amphotericin B therapy was started. At day 7, surgical debridement was performed. At day 18, the patient died and the culture of the debrided tissue showed Mucor ramosissimus. Patient 2 was a 15-year-old boy with acute lymphoblastic leukemia who developed a necrotic area in right side of the nose and palate (day 1). Liposomal amphotericin B therapy was initiated. At day 3 and 6, surgery was performed. At day 8, cultures resulted in Rhizopus oryzae, and treatment with caspofungin was added. He had progression of the infection, requiring multiple interventions. Antifungal therapy consisted of 75 days with amphotericin B and 67 days with caspofungin, with resolution. At day 152, he had a event of neutropenia and fever and died of septic shock Patient 3 was a 16-year-old girl with acute lymphoblastic leukemia who developed a necrotic lesion on the palate and right side of the nose (day 1). Direct examination of the lesion showed hyaline, non-septated hyphae. Amphotericin B therapy was initiated and surgery was performed at day 3. By day 7, there was good clinical evolution and resolution the infection. She died at day 12 because of intestinal bleeding and hypovolemic shock. Conclusions The diagnosis and treatment of mucormycosis remains a challenge. Clinical suspicion should be high in patients with risk factors, and early identification and prompt treatment with antifungals and surgical debridement can reduce mortality and improve the prognosis. The poor outcomes of the patients in this case series were mainly due to complications of the underlying disease and not because of mucormycosis. However, in the first case, delayed diagnosis and treatment might have contributed to the unfavorable outcome. The treatment of choice is liposomal amphotericin B. In case 2, a second antifungal therapy included caspofungin due to isolation of R. oryzae, sensitive to echinocandins. Posaconazole can be considered as an alternative option, but it is not available at our institution. Early identification of clinical manifestations and early multidisciplinary treatment with surgical services and antifungal are needed to eliminate the infection. Risk factors must be modified to increase patient survival.

Mediastinal Mucormycosis: Case report, review of literature and treatment with continuous liposomal amphotericin B irrigation

Mycoses ◽  
2019 ◽  
Author(s):  
Joseph D. Cooper ◽  
Robert A. Gotoff ◽  
Michael A. Foltzer ◽  
Russell A. Carter ◽  
Thomas J. Walsh
Keyword(s):  
Case Report ◽  
Amphotericin B ◽  
Liposomal Amphotericin ◽  
Liposomal Amphotericin B ◽  
Review Of Literature

scholarly journals Sporobolomyces salmonicolor: A case report of a rare cutaneous fungal infection

2019 ◽  
Vol 7 ◽  
pp. 2050313X1984415
Author(s):  
Rahina Damji ◽  
Atreyi Mukherji ◽  
Farheen Mussani
Keyword(s):  
Infectious Disease ◽  
Case Report ◽  
Fungal Infection ◽  
Amphotericin B ◽  
Liposomal Amphotericin ◽  
Multiple Organ ◽  
Liposomal Amphotericin B ◽  
Cutaneous Eruption ◽  
Organ Systems ◽  
Cutaneous Fungal Infection

We report a case of a 47-year-old male diagnosed with a cutaneous Sporobolomyces salmonicolor infection after suffering with an extensive cutaneous eruption for 4 years. Treatment can be difficult and options include voriconazole and liposomal amphotericin B. This infectious disease is extremely rare and can have extensive impact on multiple organ systems, including the skin.

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