Fusariosis in pediatric cancer patients

Abstract

Introduction: Fusariosis is an opportunistic fungal infection with increasing incidence in immunocompromised pediatric patients. Children with hematologic malignancies and those undergoing chemotherapy are at high risk due to profound neutropenia and previous antifungal exposure.

Results: Seven cases of fusariosis (species not identified) were reported. Disseminated cases: 4 (57%), presenting as fungemia, osteomyelitis (OM), and sinusitis. Superficial cases: 3 (43%), manifesting as subcutaneous nodules. The average age was 12.4 ± 2.5 years; 6 were male (86%) and 6 resided in rural areas. Acute lymphoblastic leukemia (ALL) was the most common underlying disease at induction (6 cases, 86%). All patients had an absolute neutrophil count below 100/µL for 7–8 days. Prior antifungal treatment was noted in 58%. Amphotericin B was administered in 6 cases (86%), and 2 cases (29%) received combination therapy with voriconazole. Among the four patients with disseminated disease, 50% died.