Background: Invasive fungal infections cause significant morbidity and mortality in patients with hematologic malignancies and in recipients of hematopoietic stem cell transplantation.
Case: We report a patient with relapsed acute myeloid leukemia who developed disseminated Fusarium infection during the neutropenic period following the salvage cycle of chemotherapy given at King Fahad specialist Hospital in Dammam, Saudi Arabia. The invasive fungal infection was successfully managed with a combination of voriconazole and liposomal amphotericin-B.
Discussion: Fusarium species can cause invasive infections that may become disseminated and life-threatening in patients with acute myeloid leukemia.
Conclusion: Combined antifungal therapy and recovery of neutrophil count are essential to control invasive Fusarium infections
Invasive fungal infections are described as a continuous and severe harm to human health and they are associated with at least 1.5 million deaths worldwide each year. Amphotericin B exerts its activity through hydrophobic interactions with cell membrane ergosterol, cause the rupturing or leakage of cell membrane. The antifungal azole medicine group is classified as imidazoles (clotrimazole, ketoconazole, miconazole) and triazoles (fluconazole, itraconazole, voriconazole, posaconazole, isavuconazole) that are named according to the number of nitrogen atoms in the azole ring. Flucytosine is a first-line treatment for the management of cryptococcal meningitis. The most routine adverse effects of fluconazole involve accelerated liver enzymes, gastrointestinal complaints, headache, and skin rash. If antacids, PPIs, H2 blockers administered together with ketoconazole medicines; they will reduce the blood levels of ketoconazole by increasing gastric pH because ketoconazole requires an acidic media for dissolution and systematic absorption. Griseofulvin ruptures mitotic spindle during metaphase by interacting with fungal microtubules-(-), fungal mitosis (metaphase arrest), adequate to block expansion of fungi (drug is static), preventing them from damaging.
Magnusiomyces capitatus is a rare cause of invasive fungal infection in immuno-compromised patients. We report the case of magnusiomyces infection of the central nervous system, the lungs and sinus with a palatal lesion, in a patient treated for acute myeloid leukemia. While Magnusiomyces infections pose diagnostic and therapeutic challenges, a comprehensive understanding of their epidemiology, clinical manifestations, and microbiological aspects is essential to guide effective management. The patient improved under antifungal treatments despite a reduced sensitivity of the different antifungals to the antifungogram. The important delays between chemotherapy cycles and its reduced intensity due to the Magnusiomyces infection has made managing the anticancer treatment more challenging.
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