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GIORNALE ITALIANO DI DERMATOLOGIA E VENEREOLOGIA

A Journal on Dermatology and Sexually Transmitted Diseases


Official Journal of the Italian Society of Dermatology and Sexually Transmitted Diseases
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Giornale Italiano di Dermatologia e Venereologia 2001 June;136(3):213-6

language: Italian

Disseminated fungal infection by fusarium in acute lymphatic leukemia

Carrozzo A. M., Bianchi L., Hagman J., Campione E., Chimenti S.

Università degli Studi «Tor Vergata» - Roma Clinica Dermatologica


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Fusarium is a newly emerging fungal pathogen associated with significant morbidity and mortality in the immunocompromised host. A case of disseminated fungal infection due to Fusarium in a 34 year-old patient affected by acute lymphatic leukaemia is reported. Because of chemiotherapy, neutropenia occurred and the patient presented persistent fever and myalgias followed by cutaneous lesions, which covered the total body surface Skin lesions consisted of erythematous-papular elements, many of them were vesicular bullae that evolving with a black necrotic center. Histopathologic examination showed septate branching hyphae in superficial and middle dermis. Cultures of specimens from the skin, blood, throat were positive for F. Solani. Administration of liposomial amfotericin B at dosage schedule of 6 mg/pro kg/die for a month and then of 4 mg/pro kg/die for other two months, in association with granulocyte-macrophage colony stimulating factors (GM-CSF) was a successful treatment. No relapse occurred during eights months follow-up. Fusarium spp are ubiquitous soil saprophytes food contaminants; once they were considered pathogenic only in plants, but recently they have been isolated from cutaneous infections, onycomycosis, ulcers, granulomas and cellulitis. Fusarium spp and Candida and Aspergillo are the most common disseminated fungal infections, which occur in neutropenic patients with malignancies. In immunocompromised patients persistent fever, diffused myalgias, erythematous-papular exanthema may suggest a fungal infection.

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