Disseminated infection due to Cylindrocarpon (Fusarium) lichenicola in a neutropenic patient with acute leukaemia: report of a case and review of the literature

Eur J Clin Microbiol Infect Dis. 2003 Jan;22(1):62-5. doi: 10.1007/s10096-002-0851-9. Epub 2003 Jan 18.

Abstract

Described here is an unusual case of disseminated Cylindrocarpon lichenicola (Fusarium lichenicola) infection originating from a toenail lesion of a neutropenic woman with cellulitis of the foot and underlying acute leukaemia. A computed tomography scan of the chest showed multiple, ill-defined, nodular infiltrates with alveolar consolidation. The fungus was isolated from both the nail and the skin of the infected toe. Susceptibility testing revealed low minimum inhibitory concentrations for amphotericin B (0.78 micro g/ml) and voriconazole (1.56 micro g/ml) and high minimum inhibitory concentrations (>100 micro g/ml) for fluconazole, ketoconazole and itraconazole. The infection resolved after treatment with a total dose of 1 g of amphotericin B followed by oral itraconazole and bone marrow regeneration.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Antifungal Agents / therapeutic use
  • Cellulitis / drug therapy
  • Cellulitis / microbiology*
  • Drug Therapy, Combination
  • Female
  • Follow-Up Studies
  • Foot Ulcer / drug therapy
  • Foot Ulcer / microbiology*
  • Fungemia / diagnosis
  • Fungemia / drug therapy
  • Fungemia / microbiology*
  • Fusarium / isolation & purification*
  • Humans
  • Neutropenia / immunology*
  • Opportunistic Infections / drug therapy
  • Opportunistic Infections / immunology
  • Opportunistic Infections / microbiology*
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / diagnosis
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / immunology*
  • Risk Assessment
  • Tomography, X-Ray Computed
  • Treatment Outcome

Substances

  • Antifungal Agents