Published online Aug 6, 2021. doi: 10.12998/wjcc.v9.i22.6443
Peer-review started: March 9, 2021
First decision: April 24, 2021
Revised: May 7, 2021
Accepted: May 25, 2021
Article in press: May 25, 2021
Published online: August 6, 2021
Processing time: 140 Days and 17.5 Hours
In recent years, the rate of immunosuppressed patients has increased rapidly. Invasive fungal infections usually occur in these patients, especially those who have had hematological malignances and received chemotherapy. Fusariosis is a rare pathogenic fungus, it can lead to severely invasive Fusarium infections. Along with the increased rate of immune compromised patients, the incidence of invasive Fusarium infections has also increased from the past few years. Early diagnosis and therapy are important to prevent further development to a more aggressive or disseminated infection.
We report a case of a 19-year-old male acute B-lymphocytic leukemia patient with fungal infection in the skin, eyeball, and knee joint during the course of chemotherapy. We performed skin biopsy, microbial cultivation, and molecular biological identification, and the pathogenic fungus was finally confirmed to be Fusarium solani. The patient was treated with oral 200 mg voriconazole twice daily intravenous administration of 100 mg liposomal amphotericin B once daily, and surgical debridement. Granulocyte colony-stimulating factor was administered to expedite neutrophil recovery. The disseminated Fusarium solani infection eventually resolved, and there was no recurrence at the 3 mo follow-up.
Our case illustrates the early detection and successful intervention of a systemic invasive Fusarium infection. These are important to prevent progression to a more aggressive infection. Disseminate Fusarium infection requires the systemic use of antifungal agents and immunotherapy. Localized infection likely benefits from surgical debridement and the use of topical antifungal agents.
Core Tip: Fusarium as a rare pathogenic fungus can lead to severely invasive fusariosis and is associated with high morbidity and with up to 70% mortality. The clinical manifestations of invasive Fusarium infection are varied; early diagnosis and proper therapies are essential. In such infections, the identification of fungal etiology is very important. Histopathological examination, microbial cultivation, antifungal susceptibility testing, and molecular biological identification are helpful for the diagnosis and treatment of this disease. In this case, the diagnosis was clear and the patient was successfully treated with positive efforts.