DISSEMINATED FUSARIOSIS

A 7-year-old boy with T cell acute lymphoblastic leukemia developed di sseminated hyalohyphomycosis due to Fusarium solani. The clinical feat ures included fever, severe myalgia, documented fungemia with F. solan i, an ecthyma gangrenosum-like lesion next to a peripheral venous cath eter, and disseminated pustules. Severe neutropenia due to chemotherap y was the most revelant risk factor. Histopathologic study of the ecth yma gangrenosum-like lesion, as well as pustular lesions, revealed epi dermal necrosis and an inflammatory infiltrate in the upper dermis, wi th numerous septate hyphae demonstrated by periodic acid-Schiff stain. Clinical resolution was achieved with granulocyte colony-stimulating factor and amphotericin a administration. Our case suggests that the p eripheral venous access was probably the portal of entry of the fungus .