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Disseminated Fusariosis with Secondary Hemophagocytic Lymphohistiocytosis

Year 2022, Volume: 12 Issue: 02, 69 - 73, 15.06.2022
https://doi.org/10.5799/jmid.1130139

Abstract

We report here a 7-year girl with B-Acute Lymphoblastic Leukemia (ALL) on Berlin Frankfurt Munster (BFM) based induction chemotherapy who presented with fever, cough, and painful necrotic skin lesions simulating pseudomonas sepsis. The patient was eventually diagnosed with disseminated fusariosis. While on combination antifungal therapy, fever reappeared with pancytopenia and hepatosplenomegaly, and she was subsequently diagnosed with secondary Hemophagocytic lymphohistiocytosis (HLH) and was treated using the HLH 2004 protocol. The child responded to treatment well. This report highlights the high index of clinical suspicion, appropriate investigations needed to diagnose fusariosis and secondary HLH in pediatric oncology practice promptly, and the successful treatment outcome despite having them both.

References

  • 1. Boutati EI, Anaissie EJ. Fusarium-A Significant Emerging Pathogen in Patients With Hematologic Malignancy: Ten Years’ Experience at a Cancer Center and Implications for Management. Blood 1997; 90:999–1008.
  • 2. Castagnola E, Cesaro S, Giacchino M, et al. Fungal infections in children with cancer: a prospective, multicenter surveillance study. Pediatr Infect Dis J 2006; 25:634–639.
  • 3. Nucci M, Marr KA, Queiroz-Telles F, et al. Fusarium infection in hematopoietic stem cell transplant recipients. Clin Infect Dis 2004; 38:1237–1242.
  • 4. Nucci M, Anaissie EJ, Queiroz-Telles F, et al. Outcome predictors of 84 patients with hematologic malignancies and Fusarium infection. Cancer 2003; 98:315–319.
  • 5. Mikami R, Stemmermann GN. Keratomycosis Caused by Fusarium oxysporum. Am J Clin Pathol 1958; 29:257–262.
  • 6. Liu YS, Wang NC, Ye RH, e al. Disseminated Fusarium infection in a patient with acute lymphoblastic leukemia: A case report and review of the literature. Oncol Lett 2014; 7:334–336.
  • 7. Nucci M, Anaissie E. Cutaneous infection by Fusarium species in healthy and immunocompromised hosts: implications for diagnosis and management. Clin Infect Dis 2002; 35:909–920.
  • 8. Bodey GP, Boktour M, Mays S, et al. Skin lesions associated with Fusarium infection. J Am Acad Dermatol 2002; 47:659–666.
  • 9. McCarthy MW, Katragkou A, Iosifidis E, et al. Recent Advances in the Treatment of Scedosporiosis and Fusariosis. J Fungi (Basel, Switzerland) 2018;4(2).
  • 10. Stempel JM, Hammond SP, Sutton DA, et al. Invasive Fusariosis in the Voriconazole Era: Single-Center 13-Year Experience. Open Forum Infect Dis, 2015; 2(3):ofv099.
  • 11. Nucci M, Marr KA, Vehreschild MJ, et al. Improvement in the outcome of invasive fusariosis in the last decade. Clin Microbiol Infect 2014; 20:580–585.
  • 12. Horn DL, Freifeld AG, Schuster MG, et al. Treatment and outcomes of invasive fusariosis: review of 65 cases from the PATH Alliance(®) registry. Mycoses 14; 57:652–658.
  • 13. Tortorano AM, Richardson M, Roilides E, et al. ESCMID and ECMM joint guidelines on diagnosis and management of hyalohyphomycosis: Fusarium spp., Scedosporium spp. and others.Clin Microbiol Infect 2014; 20(3):27–46.
  • 14. Rouphael NG, Talati NJ, Vaughan C, et al.Infections associated with haemophagocytic syndrome. Lancet Infect Dis 2007; 7:814–822.
  • 15. Albisetti M, Lauener RP, Gungor T, et al. Disseminated Fusarium oxysporum infection in hemophagocytic lymphohistiocytosis. Infection 2004; 32:364–366.
  • 16. Karlsson T. Secondary haemophagocytic lymphohistiocytosis: Experience from the Uppsala University Hospital. Ups J Med Sci 2015; 120:257.
Year 2022, Volume: 12 Issue: 02, 69 - 73, 15.06.2022
https://doi.org/10.5799/jmid.1130139

Abstract

References

  • 1. Boutati EI, Anaissie EJ. Fusarium-A Significant Emerging Pathogen in Patients With Hematologic Malignancy: Ten Years’ Experience at a Cancer Center and Implications for Management. Blood 1997; 90:999–1008.
  • 2. Castagnola E, Cesaro S, Giacchino M, et al. Fungal infections in children with cancer: a prospective, multicenter surveillance study. Pediatr Infect Dis J 2006; 25:634–639.
  • 3. Nucci M, Marr KA, Queiroz-Telles F, et al. Fusarium infection in hematopoietic stem cell transplant recipients. Clin Infect Dis 2004; 38:1237–1242.
  • 4. Nucci M, Anaissie EJ, Queiroz-Telles F, et al. Outcome predictors of 84 patients with hematologic malignancies and Fusarium infection. Cancer 2003; 98:315–319.
  • 5. Mikami R, Stemmermann GN. Keratomycosis Caused by Fusarium oxysporum. Am J Clin Pathol 1958; 29:257–262.
  • 6. Liu YS, Wang NC, Ye RH, e al. Disseminated Fusarium infection in a patient with acute lymphoblastic leukemia: A case report and review of the literature. Oncol Lett 2014; 7:334–336.
  • 7. Nucci M, Anaissie E. Cutaneous infection by Fusarium species in healthy and immunocompromised hosts: implications for diagnosis and management. Clin Infect Dis 2002; 35:909–920.
  • 8. Bodey GP, Boktour M, Mays S, et al. Skin lesions associated with Fusarium infection. J Am Acad Dermatol 2002; 47:659–666.
  • 9. McCarthy MW, Katragkou A, Iosifidis E, et al. Recent Advances in the Treatment of Scedosporiosis and Fusariosis. J Fungi (Basel, Switzerland) 2018;4(2).
  • 10. Stempel JM, Hammond SP, Sutton DA, et al. Invasive Fusariosis in the Voriconazole Era: Single-Center 13-Year Experience. Open Forum Infect Dis, 2015; 2(3):ofv099.
  • 11. Nucci M, Marr KA, Vehreschild MJ, et al. Improvement in the outcome of invasive fusariosis in the last decade. Clin Microbiol Infect 2014; 20:580–585.
  • 12. Horn DL, Freifeld AG, Schuster MG, et al. Treatment and outcomes of invasive fusariosis: review of 65 cases from the PATH Alliance(®) registry. Mycoses 14; 57:652–658.
  • 13. Tortorano AM, Richardson M, Roilides E, et al. ESCMID and ECMM joint guidelines on diagnosis and management of hyalohyphomycosis: Fusarium spp., Scedosporium spp. and others.Clin Microbiol Infect 2014; 20(3):27–46.
  • 14. Rouphael NG, Talati NJ, Vaughan C, et al.Infections associated with haemophagocytic syndrome. Lancet Infect Dis 2007; 7:814–822.
  • 15. Albisetti M, Lauener RP, Gungor T, et al. Disseminated Fusarium oxysporum infection in hemophagocytic lymphohistiocytosis. Infection 2004; 32:364–366.
  • 16. Karlsson T. Secondary haemophagocytic lymphohistiocytosis: Experience from the Uppsala University Hospital. Ups J Med Sci 2015; 120:257.
There are 16 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Case Report
Authors

Garima Nirmal This is me

Guruprasad Chellappan Sojamani This is me

Manjusha Nair This is me

Swapna R. Nath This is me

Priyakumari Thankamony This is me

Publication Date June 15, 2022
Published in Issue Year 2022 Volume: 12 Issue: 02

Cite

APA Nirmal, G., Sojamani, G. C., Nair, M., Nath, S. R., et al. (2022). Disseminated Fusariosis with Secondary Hemophagocytic Lymphohistiocytosis. Journal of Microbiology and Infectious Diseases, 12(02), 69-73. https://doi.org/10.5799/jmid.1130139
AMA Nirmal G, Sojamani GC, Nair M, Nath SR, Thankamony P. Disseminated Fusariosis with Secondary Hemophagocytic Lymphohistiocytosis. J Microbil Infect Dis. June 2022;12(02):69-73. doi:10.5799/jmid.1130139
Chicago Nirmal, Garima, Guruprasad Chellappan Sojamani, Manjusha Nair, Swapna R. Nath, and Priyakumari Thankamony. “Disseminated Fusariosis With Secondary Hemophagocytic Lymphohistiocytosis”. Journal of Microbiology and Infectious Diseases 12, no. 02 (June 2022): 69-73. https://doi.org/10.5799/jmid.1130139.
EndNote Nirmal G, Sojamani GC, Nair M, Nath SR, Thankamony P (June 1, 2022) Disseminated Fusariosis with Secondary Hemophagocytic Lymphohistiocytosis. Journal of Microbiology and Infectious Diseases 12 02 69–73.
IEEE G. Nirmal, G. C. Sojamani, M. Nair, S. R. Nath, and P. Thankamony, “Disseminated Fusariosis with Secondary Hemophagocytic Lymphohistiocytosis”, J Microbil Infect Dis, vol. 12, no. 02, pp. 69–73, 2022, doi: 10.5799/jmid.1130139.
ISNAD Nirmal, Garima et al. “Disseminated Fusariosis With Secondary Hemophagocytic Lymphohistiocytosis”. Journal of Microbiology and Infectious Diseases 12/02 (June 2022), 69-73. https://doi.org/10.5799/jmid.1130139.
JAMA Nirmal G, Sojamani GC, Nair M, Nath SR, Thankamony P. Disseminated Fusariosis with Secondary Hemophagocytic Lymphohistiocytosis. J Microbil Infect Dis. 2022;12:69–73.
MLA Nirmal, Garima et al. “Disseminated Fusariosis With Secondary Hemophagocytic Lymphohistiocytosis”. Journal of Microbiology and Infectious Diseases, vol. 12, no. 02, 2022, pp. 69-73, doi:10.5799/jmid.1130139.
Vancouver Nirmal G, Sojamani GC, Nair M, Nath SR, Thankamony P. Disseminated Fusariosis with Secondary Hemophagocytic Lymphohistiocytosis. J Microbil Infect Dis. 2022;12(02):69-73.