000 02889cam a2200337 4500500
005 20250121155347.0
041 _afre
042 _adc
100 1 0 _aZhong, Lingzhi
_eauthor
700 1 0 _a Song, Yinggai
_eauthor
700 1 0 _a Hu, Jian
_eauthor
700 1 0 _a Yao, Xueyan
_eauthor
700 1 0 _a Li, Tingting
_eauthor
700 1 0 _a Li, Houmin
_eauthor
245 0 0 _aSuccessful treatment of disseminated amphotericin-resistant fusariosis in a paediatric patient with acute lymphoblastic leukaemia: a case report and literature review
260 _c2022.
500 _a31
520 _aBackgroundDisseminated fusariosis is a rare and fatal infection in immunocompromised patients.ObjectivesWe report a case of disseminated amphotericin-resistant fusariosis in a paediatric patient with acute lymphoblastic leukaemia and review the features of reported disseminated fusariosis in China.Materials & MethodsCase reports of disseminated fusariosis were searched from the Chinese literature over the last two decades.ResultsThe presented case is a 15-year-old female who developed fever and multiple painful purple plaques with black necrotic centres and blood blisters. Fusarium was detected in blood and skin lesions with a high minimum inhibitory concentration (MIC) of amphotericin B (AMB) (>32 μg/mL) and a low MIC of voriconazole (VRC) (0.25 μg/mL). The Fusarium fujikuroi species complex was finally identified by rRNA gene analysis. Combination therapy of VRC and terbinafine (TRF) successfully resolved the disease after more than four months of treatment. Based on the review, the most common manifestations of disseminated fusariosis were fever, skin lesions and positive blood cultures, comprising nine cases (64.3%). Other sites of infection, including the lungs, eyes, sinuses or bone marrow, occurred in eight cases (57.1%). Seven patients (50%) were cured after monotherapy or combination therapy with AMB and VRC.ConclusionIn view of this case and the review of the literature, early identification of Fusarium infection and the appropriate antifungal drugs are critical for successful treatment. Primary therapy should consist of VRC or liposomal amphotericin B (L-AMB), with salvage therapy consisting of posaconazole (PSC). The combination of antifungals is probably necessary and more effective.
690 _aamphotericin B
690 _avoriconazole
690 _adisseminated fusariosis
690 _aterbinafine
690 _aacute lymphoblastic leukaemia
690 _aamphotericin B
690 _avoriconazole
690 _adisseminated fusariosis
690 _aterbinafine
690 _aacute lymphoblastic leukaemia
786 0 _nEuropean Journal of Dermatology | 32 | 5 | 2022-09-01 | p. 623-628 | 1167-1122
856 4 1 _uhttps://shs.cairn.info/revue-european-journal-of-dermatology-2022-5-page-623?lang=en&redirect-ssocas=7080
999 _c604544
_d604544