Ag. Smith et al., DISSEMINATED CUTANEOUS AND VASCULAR INVASION BY FUSARIUM-MONILIFORME IN A FATAL CASE OF ACUTE LYMPHOCYTIC-LEUKEMIA, Mycopathologia, 122(1), 1993, pp. 15-20
A 35 year old female patient with acute lymphocytic leukemia developed
fusariosis in which dissemination appeared to be limited to cutaneous
and vascular invasion. The first evidence of fungemia occurred nearly
seven months after initial hospitalization. The fungus was identified
as Fusarium sp. and was considered a contaminant. Two weeks later blo
od cultures were again positive for Fusarium sp. and the patient was p
laced on amphotericin B and 5-fluorocytosine therapy. The following da
y developing lesions were noted on her forearms and face; lesions ulti
mately spread to her trunk, abdomen, and lower extremities. Skin lesio
n biopsy sections revealed abundant septate and branching hyphae throu
ghout the dermis and within capillaries. Twenty-six days after the ini
tial isolation the patient died. Post-mortem blood cultures gave rise
to the same fungus, which was identified as Fusarium monoliforme. Post
mortem cultures and stains of spleen, liver, lung, and brain specimens
were all negative for fungi. The primary source and portal of entry o
f the organism remained undetermined.