Fusariosis

Fusariosis is an opportunistic mold infection. The median time from stem cell transplantation to diagnosis is 48 days. In the immunocompetent host, it can cause keratitis, onychomycosis, allergic sinusitis, or mycotoxicosis after ingestion of contaminated food.

CASES/YEAR
500 (US); 10,000 (Global)
CATEGORY
Sapronoses
AGENT TYPE
Fungi (Opportunistic Molds)
OTHER NAMES
Fusarium solani infection; Fusarium oxysporum infection;
ACUITY
Subacute/Chronic
INCUBATION
48 days (median time from stem cell transplantation to diagnosis); [ABX Guide]
INITIAL SYMPTOMS
Immunocompetent: keratitis, onychomycosis, allergic sinusitis, or mycotoxicosis after ingestion of contaminated food; Immunocompromised: disseminated infections; [Cohen]
PRECAUTIONS
COMMENTS
These are filamentous, nonpigmented fungi with acute angle branching. Skin lesions are typically erythematous, nodular, and ulcerated. An outbreak of keratitis from contaminated lens cleaning solution has been reported. Successful treatment of immunocompromised patients is dependent upon recovery from neutropenia. [ABX Guide] Risk factors are prolonged, severe neutropenia and T-cell immunodeficiency. Findings include febrile illness (not responsive to antibiotics), myalgia, sinusitis, pulmonary infection, and ecthyma gangrenosum-like skin lesions (bullae & ulcers). Blood cultures are positive in most cases of disseminated infection. [Cohen, p. 1699-1700] Findings in neutropenic patients usually include fever, pulmonary disease (infiltrates & nodules), and skin lesions. [ID, p. 2271] "Most human infections follow inhalation of conidia, but ingestion and direct inoculation can also lead to disease." [Harrison ID, p. 1028] See "Keratitis."
DIAGNOSTIC
Skin or tissue biopsy with culture; Blood culture if immunocompromised; Indistinguishable from aspergillus histologically; [ABX Guide] Blood cultures (usually negative in aspergillosis) are positive in 50% of immunocompromised patients. [PPID, p. 3228]
SCOPE
Global
SIGNS & SYMPTOMS
  • >fever
  • >myalgia
  • E rhinitis
  • S papules or plaques
  • S skin blister or vesicles
  • S skin or subcutaneous nodule
  • S ulcer of skin
  • X cystic or cavitary lesions
  • X lung infiltrates
  • *blindness
ANTIMICROBIC

Yes

VACCINE

No

ENTRY
Inhalation, Ingestion, Skin or Mucous Membranes (Includes Conjunctiva)
SOURCE
Soil or Dust (Ingesting or Inhaling), Waterborne (Ingesting, Inhaling, or Swimming)
RESERVOIR
RISK FACTORS
  • AIDS patients
  • Cancer patients
DRUG LINK
REFERENCES FOR CASES/YEAR
1. (US) No data found; Assume same cases/yr as Mucormycosis;
2. (Global) No data found; Assume same rate as Mucormycosis;