TY - JOUR
T1 - Disseminated fusariosis with cerebral involvement in a patient with acute myeloid leukemia
T2 - Successful outcome with intrathecal -and systemic antifungal treatment
AU - Risum, Malene
AU - Overgaard, Ulrik Malthe
AU - Rubek, Niclas
AU - Haastrup, Eva Kannik
AU - Hare, Rasmus Krøger
AU - Helweg-Larsen, Jannik
N1 - Copyright © 2022 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
PY - 2022/9
Y1 - 2022/9
N2 - The outcome of invasive fusariosis in hematological patients is usually dismal, particularly in patients with persistent neutropenia. We report a patient with acute myeloid leukemia (AML) with Fusarium dimerum sinusitis with hematogenic dissemination to the brain. Despite surgical debridements of the sinuses and liposomal amphotericin B, voriconazole and terbinafine, there was progression with cerebral involvement after recovery of neutropenia and with detection of F. dimerum in the cerebrospinal fluid. Topical antifungal treatment with amphotericin B deoxycholate (deoxy-AMB) intrathecally was initiated with administration three times a week. After 99 treatments of intrathecal deoxy-AMB, she had regression of the fusarium CNS lesions and is currently in complete remission from AML. This report supports the use of intrathecal amphotericin B for treatment of CNS fusariosis.
AB - The outcome of invasive fusariosis in hematological patients is usually dismal, particularly in patients with persistent neutropenia. We report a patient with acute myeloid leukemia (AML) with Fusarium dimerum sinusitis with hematogenic dissemination to the brain. Despite surgical debridements of the sinuses and liposomal amphotericin B, voriconazole and terbinafine, there was progression with cerebral involvement after recovery of neutropenia and with detection of F. dimerum in the cerebrospinal fluid. Topical antifungal treatment with amphotericin B deoxycholate (deoxy-AMB) intrathecally was initiated with administration three times a week. After 99 treatments of intrathecal deoxy-AMB, she had regression of the fusarium CNS lesions and is currently in complete remission from AML. This report supports the use of intrathecal amphotericin B for treatment of CNS fusariosis.
KW - Antifungal Agents/therapeutic use
KW - Female
KW - Fusariosis/diagnosis
KW - Fusarium
KW - Humans
KW - Leukemia, Myeloid, Acute/complications
KW - Neutropenia/drug therapy
KW - Voriconazole/therapeutic use
KW - Amphotericin B
KW - Voriconazole
KW - Intrathecal treatment
KW - Acute myeloid leukemia
UR - http://www.scopus.com/inward/record.url?scp=85130885344&partnerID=8YFLogxK
U2 - 10.1016/j.jiac.2022.04.017
DO - 10.1016/j.jiac.2022.04.017
M3 - Journal article
C2 - 35641412
VL - 28
SP - 1324
EP - 1328
JO - Journal of Infection and Chemotherapy
JF - Journal of Infection and Chemotherapy
SN - 1341-321X
IS - 9
ER -