Clinical Features and Outcomes of Invasive Fusariosis: A Case Series in a Single Center with Literature Review
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Fusarium species, which are commonly found in soil, water, and organic substrates, can cause serious infections especially in immunocompromised patients. Fusarium infection is notoriously difficult to treat, because of their inherently high minimum inhibitory concentrations (MICs) to most antifungal agents. There have been limited data on invasive fusariosis in Korea. We identified 57 patients with culture-proven fusariosis at Samsung Medical Center, Seoul, Korea, from September 2003 through January 2017. Invasive fusariosis was defined as any case with at least one positive blood culture or with concurrent involvement of 2 or more non-contiguous sites. Superficial infections such as keratitis and onychomycosis were excluded. We reported 14 cases of invasive fusariosis categorized according to the European Organization for Research and Treatment of Cancer/Mycoses Study Group criteria, of which 6 cases were fusarium fungemia. Hematologic malignancies (7/14, 50%), solid organ transplantation (2/14, 14.2%), or immunosuppressive therapy (2/14, 14.2%), were the predominant underlying conditions. The overall mortality rate was 37%, however, that of disseminated fusariosis was up to 83%. Antifungal treatment with voriconazole or liposomal amphotericin B was commonly administered. In this report, we described the clinical characteristics and treatment outcomes of invasive fusariosis in Korea. Given the high mortality in disseminated cases, invasive fusariosis is becoming a therapeutic challenge to clinicians treating immunocompromised patients.
Abstract
Fusarium species, which are commonly found in soil, water, and organic substrates, can cause serious infections especially in immunocompromised patients. Fusarium infection is notoriously difficult to treat, because of their inherently high minimum inhibitory concentrations (MICs) to most antifungal agents. There have been limited data on invasive fusariosis in Korea. We identified 57 patients with culture-proven fusariosis at Samsung Medical Center, Seoul, Korea, from September 2003 through January 2017. Invasive fusariosis was defined as any case with at least one positive blood culture or with concurrent involvement of 2 or more non-contiguous sites. Superficial infections such as keratitis and onychomycosis were excluded. We reported 14 cases of invasive fusariosis categorized according to the European Organization for Research and Treatment of Cancer/Mycoses Study Group criteria, of which 6 cases were fusarium fungemia. Hematologic malignancies (7/14, 50%), solid organ transplantation (2/14, 14.2%), or immunosuppressive therapy (2/14, 14.2%), were the predominant underlying conditions. The overall mortality rate was 37%, however, that of disseminated fusariosis was up to 83%. Antifungal treatment with voriconazole or liposomal amphotericin B was commonly administered. In this report, we described the clinical characteristics and treatment outcomes of invasive fusariosis in Korea. Given the high mortality in disseminated cases, invasive fusariosis is becoming a therapeutic challenge to clinicians treating immunocompromised patients.
참고문헌 (21)
- Anaissie E, "Fusarium. A newly recognized fungal pathogen in immunosuppressed patients", Cancer, 57, pp.2141~2145 (1986)
- Nucci M, "Fusarium infections in immunocompromised patients", Clin Microbiol Rev, 20, pp.695~704 (2007)
- Nucci M, "Outcome predictors of 84 patients with hematologic malignancies and Fusarium infection", Cancer, 98, pp.315~319 (2003)
- Boutati EI, "Fusarium, a significant emerging pathogen in patients with hematologic malignancy : ten years' experience at a cancer center and implications for management", Blood, 90, pp.999~1008 (1997)
- De Pauw B, "Revised definitions of invasive fungal disease from the European Organization for Research and Treatment of Cancer", Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group(EORTC, Clin Infect Dis, pp.2008, 46[DOI]
- Cho CT, "Fusarium solani infection during treatment for acute leukemia", J Pediatr, 83, pp.1028~1031 (1973)
- Eo SH, "Successful treatment of disseminated fusariosis with liposomal amphotericin B and voriconazole in a child undergoing chemotherapy", Korean J Pediatr Hematol Oncol, 12, pp.330~334 (2005)
- 임세웅, "급성 골수성 백혈병 환자에서 발생한 Fusarium solani에 의한전신 감염증 1예", 대한피부과학회지, 46(6), pp.846~850 (2008), 대한피부과학회
- Hue FX, "Specific detection of fusarium species in blood and tissues by a PCR technique", J Clin Microbiol, 37, pp.2434~2438 (1999)
- Lim SH, "A case of disseminated cutaneous infection caused by fusarium oxysporum in an immunocompromised patient", Korean J Med Mycol, 5, pp.24~30 (2000)
- Austen B, "Fatal disseminated fusarium infection in acute lymphoblastic leukaemia in complete remission", J Clin Pathol, 54, pp.488~490 (2001)
- Inano S, "Combination therapy of voriconazole and terbinafine for disseminated fusariosis : case report and literature review", J Infect Chemother, 19, pp.1173~1180 (2013)
- Stanzani M, "Update on the treatment of disseminated fusariosis : Focus on voriconazole", Ther Clin Risk Manag, 3, pp.1165~1173 (2007)
- Muhammed M, "Fusarium infection : report of 26 cases and review of 97 cases from the literature", Medicine(Baltimore), 92, pp.305~316 (2013)
- Kahng JM, "A case of mycotic pneumonia caused by fusarium species", Korean J Infect Dis, 22, pp.255~259 (1990)
- Park JY, "Disseminated fusarial infections in two children with acute leukemia", Korean J Pediatr Hematol Oncol, 4, pp.363~369 (1997)
- Kim MS, "Breakthrough disseminated fusariosis in an immunocompromised patient on voriconazole therapy", Int J Dermatol, 51, pp.621~623 (2012)
- 오수진, "급성 백혈병 환자에서 수두양 피부병변을 보인 파종성 Fusarium 감염 1예와 국내 파종성 Fusarium 감염증에 대한 고찰", Infection and Chemotherapy, 39(5), pp.263~269 (2007), 대한감염학회
- Cho SB, "A case of systemic fungal infection due to Fusarium oxysporum in a patient with acute lymphocytic leukemia", Korean J Med Mycol, 8, pp.122~126 (2003)
- 이지연, "백혈병환자에서 Liposomal amphotericin B로 치료된 파종성 Fusarium 감염 1예", Infection and Chemotherapy, 35(5), pp.321~324 (2003), 대한감염학회
- 오봉준, "Fusarium oxysporum에 의한 혈류감염 1예", Annals of Clinical Microbiology, 8(2), pp.189~193 (2005), 대한임상미생물학회