T. Saito et al., Disseminated Fusarium infection identified by the immunohistochemical staining in a patient with a refractory leukemia, TOH J EX ME, 187(1), 1999, pp. 71-77
The difficulty and uncertainty encountered in diagnosing a systemic mycosis
often lead to a delay in starting antifungal therapy. We reported a dissem
inated infection of multiple fungal isolates including Fusarium species dur
ing donor leukocyte transfusion (DLT) after allogeneic bone marrow transpla
ntation in a 20-year-old woman with a refractory leukemia. Skin lesions are
the feature of Fusarium and occur in the early period of the infection. In
this case, during immunosuppression state after DLT, she presented with th
e whole body ache and erythematous lesions which appeared rapidly on her tr
unk and extremities. While administration of amphotericin B was started, he
r condition was further deteriorated and she died. autopsy materials reveal
ed that she had multiple fungal infection with different isolates, includin
g Aspergillus and Candida in the brain, lung and liver, but not in the skin
. With the immunohistochemical staining with specific antibody, Fusarium or
Aspergillus infection was identified from the biopsy skin or autopsy brain
, respectively. This rapid and specific immunohistochemical method may be u
seful for the diagnosis and treatment of invasive fungal infection without
delay. (C) 1999 Tohoku University Medical Press.