Clinical spectrum of fusariosis from a tertiary care center in India- a retrospective study
,
Abstract
Background and Objectives: Fusarium spp. is an emerging pathogen that presents with varied clinical presentations but there are very few studies from India that elaborate on the spectrum of infection caused by the fungus. Hence, the present study was conducted in our institute to understand the clinical spectrum of fusariosis.
Materials and Methods: The present study was a retrospective study conducted at a tertiary care institute, in Hyderabad, Telangana, India for four years from January 2018 to December 2022. All the patients with clinically significant isolation of Fusarium spp. from various samples were included in the study.
Results: There were 25 cases of fusariosis diagnosed during the study period. Fusarium was isolated predominantly from debrided tissue following road traffic accidents in 12/25 (84%) of the cases, nails in 3/25 (12%) and superficial leg ulcer in 1/25 (4%) of the cases. Speciation was done for four patients. Three were Fusarium incarnatum and one was Fusarium solani. The patients were treated surgically and with/without antifungal therapy and were discharged in a stable condition.
Conclusion: Traumatic injuries were the major cause of infections in the present study. As Fusarium is a virulent and highly resistant pathogen, an early suspicion and an appropriate diagnosis would lead to a better outcome in these patients.
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2. O'Donnell K, Al-Hatmi AMS, Aoki T, Brankovics B, Cano-Lira JF, Coleman JJ, et al. No to Neocosmospora: phylogenomic and practical reasons for continued inclusion of the Fusarium solani species complex in the Genus Fusarium. mSphere 2020; 5(5): e00810-20.
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12. Tupaki-Sreepurna A, Kindo AJ. Fusarium: The versatile pathogen. Indian J Med Microbiol 2018; 36: 8-17.
13. Homa M, Galgóczy L, Manikandan P, Narendran V, Sinka R, Csernetics Á, et al. South Indian isolates of the Fusarium solani species complex from clinical and environmental samples: identification, antifungal susceptibilities, and virulence. Front Microbiol 2018; 9: 1052.
14. Antifungal resistance surveillance network. “Standard operating procedure for fungal identification and detection of antifungal resistance.”2nd edition 2019.Indian Council of Medical Research, New Delhi. Accessed December 2nd, 2023. Available at https://main.icmr.nic.in/sites/default/files/guidelines/Mycology_SOP_2nd_Ed_2019.pdf
15. Nucci M, Anaissie E. Cutaneous infection by Fusarium species in healthy and immunocompromised hosts: implications for diagnosis and management. Clin Infect Dis 2002; 35: 909-920.
16. Hayashida MZ, Seque CA, Enokihara MMSES, Porro AM. Disseminated fusariosis with cutaneous involvement in hematologic malignancies: report of six cases with high mortality rate. An Bras Dermatol 2018; 93: 726-729.
17. Samrah S, Sweidan A, Aleshawi A, Ayesh M. Fusarium-induced cellulitis in an immunocompetent patient with sickle cell disease: a case report. J Investig Med High Impact Case Rep 2020; 8: 2324709620934303.
18. Mohaghegh F, Abtahi-Naeini B, Nasri E, Badiee P, Morovati H, Fakhim H, et al. Fusarium proliferatum-induced chronic lip ulcer: successful treatment with itraconazole: a case report. J Med Case Rep 2022; 16: 346.
19. Nir-Paz R, Strahilevitz J, Shapiro M, Keller N, Goldschmied-Reouven A, Yarden O, et al. Clinical and epidemiological aspects of infections caused by fusarium species: a collaborative study from Israel. J Clin Microbiol 2004; 42: 3456-3461.
20. Hiebert RM, Welliver RC, Yu Z. Fusarium osteomyelitis in a patient with Pearson syndrome: case report and review of the literature. Open Forum Infect Dis 2016; 3: ofw183.
21. Uemura EVG, Barbosa MDS, Simionatto S, Al-Harrasi A, Al-Hatmi AMS, Rossato L. Onychomycosis caused by Fusarium species. J Fungi (Basel) 2022; 8: 360.
22. Al-Hatmi AMS, Curfs-Breuker I, de Hoog GS, Meis JF, Verweij PE. antifungal susceptibility testing of Fusarium: A practical approach. J Fungi (Basel) 2017; 3: 19.
23. Blaize M, Normand A-C, Imbert S, Al-Hatmi AMS, Chryssanthou E, Cassaing S, et al. Antifungal susceptibility of 182 Fusarium species isolates from 20 European centers: Comparison between EUCAST and Gradient Concentration Strip Methods. Antimicrob Agents Chemother 2021; 65(12): e0149521.
24. Tortorano AM, Richardson M, Roilides E, van Diepeningen A, Caira M, Munoz P, et al. ESCMID and ECMM joint guidelines on diagnosis and management of hyalohyphomycosis: Fusarium spp., Scedosporium spp. and others. Clin Microbiol Infect 2014; 20 Suppl 3: 27-46.
25. McCarthy MW, Katragkou A, Iosifidis E, Roilides E, Walsh TJ. Recent advances in the treatment of scedosporiosis and fusariosis. J Fungi (Basel) 2018; 4: 73.
26. Al-Hatmi AMS, Bonifaz A, Ranque S, Sybren de Hoog G, Verweij PE, Meis JF. Current antifungal treatment of fusariosis. Int J Antimicrob Agents 2018; 51: 326-332.
27. Bourgeois GP, Cafardi JA, Sellheyer K, Andea AA. Disseminated Fusarium infection originating from paronychia in a neutropenic patient: a case report and review of the literature. Cutis 2010; 85: 191-194.
2. O'Donnell K, Al-Hatmi AMS, Aoki T, Brankovics B, Cano-Lira JF, Coleman JJ, et al. No to Neocosmospora: phylogenomic and practical reasons for continued inclusion of the Fusarium solani species complex in the Genus Fusarium. mSphere 2020; 5(5): e00810-20.
3. Nucci M, Anaissie E. Fusarium infections in immunocompromised patients. Clin Microbiol Rev 2007; 20: 695-704.
4. Nucci M, Barreiros G, Akiti T, Anaissie E, Nouér SA. Invasive fusariosis in patients with hematologic diseases. J Fungi (Basel) 2021; 7: 815.
5. Garnica M, Nucci M. Epidemiology of fusariosis. Curr Fungal Infect Rep 2013; 7: 301-305.
6. Thomas B, Audonneau NC, Machouart M, Debourgogne A. Fusarium infections: Epidemiological aspects over 10 years in a university hospital in France. J Infect Public Health 2020; 13: 1089-1093.
7. Batista BG, Chaves MA, Reginatto P, Saraiva OJ, Fuentefria AM. Human fusariosis: An emerging infection that is difficult to treat. Rev Soc Bras Med Trop 2020; 53: e20200013.
8. Giacobbe DR, Riccardi N, Vena A, Bassetti M. Mould infections of traumatic wounds: a brief narrative review. Infect Dis Ther 2020; 9: 1-15.
9. Kronen R, Liang SY, Bochicchio G, Bochicchio K, Powderly WG, Spec A. Invasive fungal infections secondary to traumatic injury. Int J Infect Dis 2017; 62: 102-111.
10. Chen H-H, Shih P-K. Fusarium infection-induced partial failure of free anterolateral thigh musculocutaneous flap: Case report. SAGE Open Med Case Rep 2019; 7: 2050313X19841963.
11. Mamali V, Koutserimpas C, Manoloudaki K, Zarkotou O, Samonis G, Vrioni G. Necrotizing skin and soft tissue infection due to Syncephalastrum species and Fusarium solani species complex following open tibia fracture. Diagnostics (Basel) 2022; 12: 1163.
12. Tupaki-Sreepurna A, Kindo AJ. Fusarium: The versatile pathogen. Indian J Med Microbiol 2018; 36: 8-17.
13. Homa M, Galgóczy L, Manikandan P, Narendran V, Sinka R, Csernetics Á, et al. South Indian isolates of the Fusarium solani species complex from clinical and environmental samples: identification, antifungal susceptibilities, and virulence. Front Microbiol 2018; 9: 1052.
14. Antifungal resistance surveillance network. “Standard operating procedure for fungal identification and detection of antifungal resistance.”2nd edition 2019.Indian Council of Medical Research, New Delhi. Accessed December 2nd, 2023. Available at https://main.icmr.nic.in/sites/default/files/guidelines/Mycology_SOP_2nd_Ed_2019.pdf
15. Nucci M, Anaissie E. Cutaneous infection by Fusarium species in healthy and immunocompromised hosts: implications for diagnosis and management. Clin Infect Dis 2002; 35: 909-920.
16. Hayashida MZ, Seque CA, Enokihara MMSES, Porro AM. Disseminated fusariosis with cutaneous involvement in hematologic malignancies: report of six cases with high mortality rate. An Bras Dermatol 2018; 93: 726-729.
17. Samrah S, Sweidan A, Aleshawi A, Ayesh M. Fusarium-induced cellulitis in an immunocompetent patient with sickle cell disease: a case report. J Investig Med High Impact Case Rep 2020; 8: 2324709620934303.
18. Mohaghegh F, Abtahi-Naeini B, Nasri E, Badiee P, Morovati H, Fakhim H, et al. Fusarium proliferatum-induced chronic lip ulcer: successful treatment with itraconazole: a case report. J Med Case Rep 2022; 16: 346.
19. Nir-Paz R, Strahilevitz J, Shapiro M, Keller N, Goldschmied-Reouven A, Yarden O, et al. Clinical and epidemiological aspects of infections caused by fusarium species: a collaborative study from Israel. J Clin Microbiol 2004; 42: 3456-3461.
20. Hiebert RM, Welliver RC, Yu Z. Fusarium osteomyelitis in a patient with Pearson syndrome: case report and review of the literature. Open Forum Infect Dis 2016; 3: ofw183.
21. Uemura EVG, Barbosa MDS, Simionatto S, Al-Harrasi A, Al-Hatmi AMS, Rossato L. Onychomycosis caused by Fusarium species. J Fungi (Basel) 2022; 8: 360.
22. Al-Hatmi AMS, Curfs-Breuker I, de Hoog GS, Meis JF, Verweij PE. antifungal susceptibility testing of Fusarium: A practical approach. J Fungi (Basel) 2017; 3: 19.
23. Blaize M, Normand A-C, Imbert S, Al-Hatmi AMS, Chryssanthou E, Cassaing S, et al. Antifungal susceptibility of 182 Fusarium species isolates from 20 European centers: Comparison between EUCAST and Gradient Concentration Strip Methods. Antimicrob Agents Chemother 2021; 65(12): e0149521.
24. Tortorano AM, Richardson M, Roilides E, van Diepeningen A, Caira M, Munoz P, et al. ESCMID and ECMM joint guidelines on diagnosis and management of hyalohyphomycosis: Fusarium spp., Scedosporium spp. and others. Clin Microbiol Infect 2014; 20 Suppl 3: 27-46.
25. McCarthy MW, Katragkou A, Iosifidis E, Roilides E, Walsh TJ. Recent advances in the treatment of scedosporiosis and fusariosis. J Fungi (Basel) 2018; 4: 73.
26. Al-Hatmi AMS, Bonifaz A, Ranque S, Sybren de Hoog G, Verweij PE, Meis JF. Current antifungal treatment of fusariosis. Int J Antimicrob Agents 2018; 51: 326-332.
27. Bourgeois GP, Cafardi JA, Sellheyer K, Andea AA. Disseminated Fusarium infection originating from paronychia in a neutropenic patient: a case report and review of the literature. Cutis 2010; 85: 191-194.
| Files | ||
| Issue | Vol 16 No 1 (2024) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijm.v16i1.14884 | |
| Keywords | ||
| Traffic accidents; Fusarium; Voriconazole | ||
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How to Cite
1.
Sudhaharan S, Pamidimukkala U, Singh KN, Chavali P. Clinical spectrum of fusariosis from a tertiary care center in India- a retrospective study. Iran J Microbiol. 2024;16(1):145-150.
