Acremonium strictum fungaemia in a paediatric immunocompromised patient: diagnosis and treatment difficulties

Mycopathologia. 2010 Sep;170(3):161-4. doi: 10.1007/s11046-010-9306-5. Epub 2010 Mar 26.

Abstract

During the past two decades, an increasing number of unusual moulds has been reported as responsible for septicaemia and systemic or disseminated infections in immunocompromised patients. Investigation of fever in a 10-year-old boy with acute myeloblastic leukaemia, including blood cultures on selective media, allowed the diagnosis of a fungaemia due to the slow-growing fungus Acremonium strictum. The patient recovered with liposomal amphotericin B (AmB) and voriconazole, followed by voriconazole alone due to AmB resistance. Facing a neutropenic patient with fever, clinicians usually suspect bacterial or viral aetiologies. This case, however, illustrates the need for mycological analysis of blood samples in febrile neutropenic patients and for antifungal susceptibility testing.

Publication types

  • Case Reports

MeSH terms

  • Acremonium / isolation & purification*
  • Amphotericin B / therapeutic use
  • Antifungal Agents / therapeutic use
  • Blood / microbiology
  • Child
  • Fever / etiology
  • Fungemia / diagnosis*
  • Fungemia / drug therapy
  • Fungemia / microbiology
  • Humans
  • Immunocompromised Host
  • Leukemia, Myeloid, Acute / complications*
  • Leukemia, Myeloid, Acute / drug therapy
  • Male
  • Neutropenia / etiology
  • Pyrimidines / therapeutic use
  • Triazoles / therapeutic use
  • Voriconazole

Substances

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