Abstract
Fusarium species are the second leading cause of disseminated mold infections in immunocompromised patients. The high mortality caused by such infections is attributed to the high resistance of Fusarium species to current antifungal agents. We report the first case of disseminated fusariosis after the use of alemtuzumab, an anti-CD52 monoclonal antibody, in a patient who presented with striking cutaneous and oral cavity lesions. Case reports of combination antifungal therapy for disseminated fusariosis in immunocompromised patients were reviewed. Among 19 published cases in the last 10 years plus this patient, the patients in 14 cases (70%) responded positively to combination antifungal therapy. A clinical response was achieved in seven cases before resolution of neutropenia.
MeSH terms
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Adult
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Alemtuzumab
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Amphotericin B / pharmacology
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Amphotericin B / therapeutic use
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Antibodies, Monoclonal, Humanized / adverse effects
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Antibodies, Monoclonal, Humanized / therapeutic use
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Antifungal Agents / pharmacology
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Antifungal Agents / therapeutic use*
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Antineoplastic Agents / adverse effects
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Antineoplastic Agents / therapeutic use
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Combined Modality Therapy
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Deoxycholic Acid / pharmacology
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Deoxycholic Acid / therapeutic use
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Drug Combinations
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Drug Therapy, Combination
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Fever
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Fusariosis / diagnosis*
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Fusariosis / microbiology
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Fusariosis / therapy
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Fusarium / cytology
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Fusarium / drug effects
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Fusarium / isolation & purification*
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Granulocytes
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Humans
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Immunocompromised Host
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Leukocyte Transfusion
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Lymphoma, T-Cell, Cutaneous / complications
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Lymphoma, T-Cell, Cutaneous / drug therapy
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Male
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Microbial Sensitivity Tests
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Neutropenia
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Pyrimidines / pharmacology
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Pyrimidines / therapeutic use
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Skin Neoplasms / complications
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Skin Neoplasms / drug therapy
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Triazoles / pharmacology
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Triazoles / therapeutic use
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Voriconazole
Substances
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Antibodies, Monoclonal, Humanized
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Antifungal Agents
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Antineoplastic Agents
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Drug Combinations
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Pyrimidines
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Triazoles
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Deoxycholic Acid
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Alemtuzumab
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Amphotericin B
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amphotericin B, deoxycholate drug combination
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Voriconazole