Disseminated Fusarium solani infection in a child with acute lymphocytic leukemia: A case report and literature review

Abstract

Background: Although invasive mycosis is a common complication of hematologic malignancies, invasive Fusarium infection, especially systemic disseminated Fusarium infection is rare, which has a high mortality due to remarkable intrinsic drug resistance. Result: We reported a case of 5-year-old high-risk acute lymphocytic leukemia (ALL) female patient complicated with disseminated Fusarium solani infection during the course of chemotherapy. After diagnosis of ALL, the case was treated according to the South China Children's Leukemia Group-ALL-2016 protocol, and achieved a molecular complete response. On the seventh day of reinduction chemotherapy, she experienced endophthalmitis in the right eye along with recurrent high fever. Three days later, endophthalmitis spread to the left eye, blood culture and next-generation sequencing returned positive result for Fusarium solani. The patient was subsequently treated with antifungal therapy including Amphotericin B, Voriconazole and Posaconazole together with supportive treatments, but the effects were less satisfying. The patient then developed endocarditis, encephalitis, arthritis and other disseminated lesions caused by Fusarium solani infection, and eventually died of multiple organ failure. Conclusion: This case we reported highlights the lethality of disseminated Fusarium species infection in immunocompromised patients. Therefore, early diagnosis and timely anti-infective treatments are of utmost importance as that helps in controlling the spread of infection thereby leading to a favorable outcome.

Keywords

• Acute lymphocytic leukemia
• Disseminated infection
• Fusarium solani
• Endophthalmitis
• Endocarditis