Disseminated fusariosis in patients with acute leukemia: a retrospective analysis of three cases

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  • KUROSAWA Shuhei
    Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital
  • SEKIYA Noritaka
    Department of Clinical Laboratory, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital
  • MURAOSA Yasunori
    Medical Mycology Research Center, Chiba University
  • KAMEI Katsuhiko
    Medical Mycology Research Center, Chiba University
  • NAGATA Akihito
    Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital
  • YAMADA Yuta
    Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital
  • KONISHI Tatsuya
    Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital
  • TAKEZAKI Toshiaki
    Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital
  • KAITO Satoshi
    Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital
  • SAKAGUCHI Masahiro
    Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital
  • HARADA Kaito
    Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital
  • YASUDA Shunichiro
    Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital
  • YOSHIOKA Kosuke
    Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital
  • INAMOTO Kyoko
    Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital
  • TOYA Takashi
    Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital
  • IGARASHI Aiko
    Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital
  • NAJIMA Yuho
    Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital
  • MUTO Hideharu
    Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital
  • DOKI Noriko
    Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital
  • KOBAYASHI Takeshi
    Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital
  • KAKIHANA Kazuhiko
    Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital
  • SAKAMAKI Hisashi
    Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital
  • OHASHI Kazuteru
    Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital

Bibliographic Information

Other Title
  • 急性白血病の経過中に播種性フザリウム症を発症した3例の後方視的検討
  • 症例報告 急性白血病の経過中に播種性フザリウム症を発症した3例の後方視的検討
  • ショウレイ ホウコク キュウセイ ハッケツビョウ ノ ケイカ チュウ ニ ハシュセイ フザリウムショウ オ ハッショウ シタ 3レイ ノ コウホウ シテキ ケントウ

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<p>We report three cases of fusariosis that occurred during the treatment of acute leukemia, during the past 5 years at our institution. Case 1: A 70-year-old male with relapsed and refractory acute lymphoblastic leukemia (ALL) developed fever and multiple nodular lesions in both the lungs. Blood culture that was subsequently obtained revealed Fusarium species. Treatment with liposomal-amphotericin B (L-AMB) was ineffective, and the condition of the patient deteriorated rapidly leading to death. Case 2: A 28-year-old male with T-ALL developed echthyma gangrenosum (EG) ulcers on the scrotum during conditioning for transplantation. Antifungal therapy with L-AMB was ineffective, and later, itraconazole and micafungin (MCFG) were introduced. However, the engraftment was not achieved, and the patient died on day 27. Microbiological examination of EG samples collected on day 13 revealed infection by Fusarium species post mortem. Case 3: A 50-year-old male with blast crisis of chronic myeloid leukemia developed EG primarily on the trunk during chemotherapy. The patient died without any response to L-AMB and MCFG. A culture obtained from EG on day 19 yielded Fusarium species, post mortem. The prognosis of fusariosis is extremely poor. However, skin lesions such as EG may assist in the early diagnosis of the disseminated disease.</p>

Journal

  • Rinsho Ketsueki

    Rinsho Ketsueki 58 (12), 2375-2379, 2017

    The Japanese Society of Hematology

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