Septic arthritis as breakthrough invasive fusariosis after cord blood transplantation

Shinichi Katsuoka; Hidehiro Itonaga; Yasushi Sawayama; Masahiko Chiwata; Haruka Watanabe; Yuichi Yamada; Machiko Fujioka; Takeharu Kato; Shinya Sato; Koji Ando; Masato Tashiro; Takahiro Takazono; Yoshitaka Imaizumi; Koichi Izumikawa; Katsunori Yanagihara; Hiroshi Mukae; Yasushi Miyazaki

Leukemia Research Reports (Jan 2024)

Septic arthritis as breakthrough invasive fusariosis after cord blood transplantation

Shinichi Katsuoka,
Hidehiro Itonaga,
Yasushi Sawayama,
Masahiko Chiwata,
Haruka Watanabe,
Yuichi Yamada,
Machiko Fujioka,
Takeharu Kato,
Shinya Sato,
Koji Ando,
Masato Tashiro,
Takahiro Takazono,
Yoshitaka Imaizumi,
Koichi Izumikawa,
Katsunori Yanagihara,
Hiroshi Mukae,
Yasushi Miyazaki

Affiliations

Shinichi Katsuoka: Department of Hematology, Nagasaki University Hospital, Nagasaki, Japan; Department of Hematology, Nagasaki University Graduate School of Biomedical Sciences, Japan
Hidehiro Itonaga: Transfusion and Cell Therapy Unit, Nagasaki University Hospital, Nagasaki, Japan; Corresponding author at: Transfusion and Cell Therapy Unit, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852-8501, Nagasaki, Japan.
Yasushi Sawayama: Department of Hematology, Japanese Red Cross Nagasaki Genbaku Hospital, Nagasaki, Japan
Masahiko Chiwata: Department of Hematology, Japan Community Healthcare Organization, Isahaya General Hospital, Isahaya, Japan
Haruka Watanabe: Department of Hematology, National Hospital Organization Nagasaki Medical Center, Ohmura, Japan
Yuichi Yamada: Department of Hematology, Nagasaki University Hospital, Nagasaki, Japan; Department of Hematology, Nagasaki University Graduate School of Biomedical Sciences, Japan
Machiko Fujioka: Department of Hematology, Nagasaki University Graduate School of Biomedical Sciences, Japan; Department of Hematology, Sasebo City General Hospital, Sasebo, Japan
Takeharu Kato: Department of Hematology, Nagasaki University Hospital, Nagasaki, Japan
Shinya Sato: Department of Hematology, Nagasaki University Hospital, Nagasaki, Japan
Koji Ando: Department of Hematology, Nagasaki University Hospital, Nagasaki, Japan
Masato Tashiro: Department of Infectious Diseases, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
Takahiro Takazono: Department of Infectious Diseases, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan; Department of Respiratory Medicine, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
Yoshitaka Imaizumi: Department of Hematology, National Hospital Organization Nagasaki Medical Center, Ohmura, Japan
Koichi Izumikawa: Department of Infectious Diseases, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
Katsunori Yanagihara: Department of Laboratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
Hiroshi Mukae: Department of Respiratory Medicine, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
Yasushi Miyazaki: Department of Hematology, Nagasaki University Hospital, Nagasaki, Japan; Department of Hematology, Nagasaki University Graduate School of Biomedical Sciences, Japan; Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan

Journal volume & issue: Vol. 22
p. 100483

Abstract

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A 63-year-old male received a third allogeneic hematopoietic stem cell transplantation with voriconazole prophylaxis for relapsed acute myeloid leukemia. He developed septic arthritis without any typical skin lesions due to fungal infection on day 42. Treatment with liposomal amphotericin B was initiated following surgical debridement; however, he died of progressive fungal infection. Ribosomal DNA sequencing identified Fusarium solani species complex (FSSC) harboring voriconazole resistance. This clinical course indicates that breakthrough invasive fusariosis (azole-resistant FSSC infection) needs to be considered as a pathogen when patients with hematological malignancies develop septic arthritis without typical skin lesions during voriconazole prophylaxis.

Published in Leukemia Research Reports

ISSN: 2213-0489 (Online)
Publisher: Elsevier
Country of publisher: Netherlands
LCC subjects: Medicine: Internal medicine: Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Website: http://www.journals.elsevier.com/leukemia-research-reports/

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