Fusarium brain abscess: case report and literature review

Mycoses. 2015 Jan;58(1):22-6. doi: 10.1111/myc.12271. Epub 2014 Dec 5.

Abstract

Severely immunocompromised patients such as those with haematological malignancies and haematopoietic stem cell transplant recipients are at an increased risk of acquiring invasive mould infections. Fusarium, a ubiquitous fungus, can cause potentially fatal infections in such hosts. It usually manifests as skin lesions, fevers and sino-pulmonary infections. Brain abscesses have been reported, but are relatively uncommon. We report a case of a 50-year-old patient with acute lymphocytic leukaemia and failed autologous peripheral stem cell transplant that presented with new onset seizures and was found to have Fusarium solani brain abscess. Nasal route was the presumed mode of entry of the fungus into the cerebrum. Treatment comprised surgical excision of the lesion, and antimycotic therapy with liposomal amphotericin B and voriconazole. Despite aggressive therapy, patient succumbed to the disease. We have provided an overview of infections secondary to Fusarium, along with a review of the central nervous system involvement by this pathogenic mould.

Keywords: Fusarium; abscess; stem cell transplant.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Amphotericin B / administration & dosage
  • Antifungal Agents / therapeutic use
  • Brain Abscess* / diagnostic imaging
  • Brain Abscess* / drug therapy
  • Brain Abscess* / microbiology
  • Central Nervous System Fungal Infections* / diagnostic imaging
  • Central Nervous System Fungal Infections* / drug therapy
  • Central Nervous System Fungal Infections* / microbiology
  • Fatal Outcome
  • Female
  • Fusariosis / diagnostic imaging
  • Fusariosis / drug therapy
  • Fusariosis / microbiology
  • Fusarium / cytology
  • Fusarium / isolation & purification
  • Humans
  • Immunocompromised Host
  • Middle Aged
  • Peripheral Blood Stem Cell Transplantation
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / complications*
  • Radiography
  • Seizures
  • Voriconazole / administration & dosage
  • Voriconazole / therapeutic use

Substances

  • Antifungal Agents
  • liposomal amphotericin B
  • Amphotericin B
  • Voriconazole