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Fungal Keratitis Due to Fusarium
Published in Mahendra Rai, Marcelo Luís Occhiutto, Mycotic Keratitis, 2019
Alexandro Bonifaz, Lorena Gordillo-García, Scarlett Fest-Parra, Andrés Tirado-Sánchez, Karla García-Carmona
Fusarium causes a wide spectrum of infections in humans, termed fusariosis or hyalohyphomycosis, including superficial (keratitis, intertrigo, onychomycosis), locally invasive (cellulitis, sinusitis), deep or disseminated infections, the last occurring almost exclusively in severely immunocompromised patients (Nucci et al. 2015, Tupaki-Sreepurna and Kindo 2018).
Fungal infections causing emergencies
Published in Biju Vasudevan, Rajesh Verma, Dermatological Emergencies, 2019
R. Madhu, Pradeesh Arumugam, V. Hari Pankaj
Fusariosis is the second most common mold infection in immunocompromised patients, next to aspergillosis [24,25]. The most common Fusarium sp. is F. solani followed by F. oxysporum and F. moniliforme. Skin involvement is common and usually precedes fungemia by about 5 days. In immunocompromised patients, skin lesions are disseminated in about 88% of fusariosis, while it is localized in 93% of immunocompetent patients.
Fusarium
Published in Dongyou Liu, Laboratory Models for Foodborne Infections, 2017
Palanisamy Manikandan, Coimbatore Subramanian Shobana, Mónika Homa, Sándor Kocsubé, János Varga, Muthusamy Chandrasekaran, Naiyf S. Alharbi, Venkatapathy Narendran, Csaba Vágvölgyi, László Kredics
The members of the genus Fusarium are hyaline filamentous fungi and are found largely as saprophytic organisms in soil. Fusaria cause a range of infections collectively known as fusariosis and have been documented as etiological agents in localized tissue infections, keratitis, endophthalmitis, septic arthritis, cystitis, peritonitis, brain abscesses, and breast abscess. The mycotoxins of these fungi are involved in the infectious processes and may serve as potential virulence factors. Fusarium is also one of the major fungal genera associated with maize and other cereals throughout the world. Several species are the most prolific producers of mycotoxins and are frequently associated with mycotoxicoses in both humans and animals. This chapter intends to provide an overview about the rodents (rats and mice) and mammalian cell lines that were most recently used as laboratory models to study Fusarium mycotoxicoses.
Evolution of antifungals for invasive mold infections in immunocompromised hosts, then and now
Published in Expert Review of Anti-infective Therapy, 2023
Zoe Freeman Weiss, Jessica Little, Sarah Hammond
Fusariosis is the second most common invasive hyaline mold infection after invasive aspergillosis [77]. Fusariosis is caused by a variety of species, including Fusarium solani complex (including F. falciforme, formerly known as Acremonium falciforme; and F. lichenicola, formerly known as Cylindrocarpon lichenicola), F. oxysporum, F. (Gibberella) fujikuroi species complex [78]. Fusariosis can present with pulmonary, ocular, cutaneous, or disseminated disease. Skin lesions are very common (60–80%) and mortality ranges from 50 to 70% in immunocompromised hosts [78–82]. Fusarium is typically diagnosed through fungal culture or sequencing of involved tissue, though occasionally may be identified in routine blood cultures. Similar to IA, surgical debridement, early systemic antifungal therapy, and reversal of immunosuppression constitute the therapeutic approach to fusariosis.
Disseminated fusariosis in immunocompromised children: a case series and review of literature
Published in Journal of Chemotherapy, 2021
M. P. Riojas Hernández, D. Cisneros Saldaña, D. N. Vaquera Aparicio, J. I. Castillo Bejarano, A. H. Mascareñas de los Santos, H. Villanueva-Lozano, J. Treviño-Rangel Rogelio de, M. E. De la O Cavazos
Currently, there are no clinical trials or systematic reviews regarding the use of combined therapy in disseminated fusariosis in children. The evidence to date has been obtained from a set of case series and expert opinions. Therefore, the experience reported in different parts of the world approves this behavior due to the high mortality present in this population.14 In conclusion, we support a combination treatment approach on immunocompromised children.
Fusariosis: an update on therapeutic options for management
Published in Expert Opinion on Orphan Drugs, 2021
Laila S Al Yazidi, Abdullah M. S. Al-Hatmi
Data supporting combination therapy for invasive fusariosis are limited and anecdotal [3,4,9]. It has been applied in treatment of deep and disseminated fusariosis as an attempt to improve outcomes in this patient population [3,4]. Al-Hatmi et al. reported 70% in vitro synergism using natamycin and voriconazole against Fusarium strains causing keratitis at clinically achievable serum concentrations [43] The same authors also reported some synergism of itraconazole and micafungin, and to a lesser extent also with natamycin and voriconazole [43]. Spader et al. observed some synergism with the combination of amphotericin B and caspofungin (59.3%), 5-flucytosine (59.3%), rifampicin (68.7%), and voriconazole (37.5%) [44]. Another study showed that in vitro data suggest most favorable synergism with the combination of terbinafine and voriconazole (79% of tested strains), followed by the combination of voriconazole and AMB (17% of tested strains) [45]. In clinical practice, voriconazole and AMB combination has been commonly used for the management of invasive fusariosis despite the theoretical concerns of potential antagonism with this combination [46]. Using voriconazole alone or in combination with other antifungal agents was suggested to improve survival. This therapy has been applied to eight case reports and all reported clinical response [4]. Jenks et al. reported five patients with disseminated fusariosis; two received liposomal amphotericin B and died, and three received voriconazole either as a monotherapy or a combination therapy and survived [47]. Although in vitro data suggest potent activity of terbinafine in combination with voriconazole and amphotericin B against Fusarium, Stempel et al. reported modest results in eight patients [48]. Fusarium species exhibit intrinsic resistance to all the echinocandins with very high MICs of >16 mg/L [1,3]. However, some studies reported its efficacy in some patients with neutropenia and invasive fusariosis when used in combination with voriconazole [49]. Several other antifungal regimens have been tried successfully for management of fusariosis but their benefit was not consistently shown and further investigation is required [4].