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A Case of Disseminated Fusarium Infection Mimicking Varicella Skin Eruption in Patient with Acute Leukemia and Review of Korean Literatures
Su-Jin Oh, M.D.1, Hee-Sun Jeong, M.D.1, Joon-Sung Kim. M.D.1, Tae-Seok Kim, M.D.1 , Byung-Sik Cho, M.D.1, Su-Mi Choi, M.D.1, Myungshin Kim, M.D.2 , Youn Soo Lee, M.D.3, Suk Lee, M.D.1, and Wan-Sik Shin, M.D.1
1Department of Internal Medicine, 2Department of Laboratory Medicine and 3Department of Hospital Pathology College of Medicine, The Catholic University of Korea, Seoul, Korea
Vol.39 Num.5 (p263~269)
Recently, we experienced a case of disseminated fusarial blood stream infection with varicelloid skin eruptions, who had suffered from persistent neutropenic fever after salvage chemotherapy for relapsed acute lymphocytic leukemia (ALL). Neutropenia continued in spite of G-CSF and granulocyte transfusion, and he failed to respond to conventional amphotericin B initially, and then liposomal amphotericin B and voriconazole combination therapy. Disseminated fusariosis can be diagnosed by blood cultures in 50% of patients and present skin lesions in more than 80% of patients. So, typical skin lesions are important clue to diagnose of the disseminated fusariosis. However, many skin lesions in immunocompromised hosts are due to various infectious and non-infectious causes. So, this case shows that it is important to obtain biopsy specimens of skin lesions for histopathologic examination, culture and staining. Here, we present our case with the review of the literatures reported in our country, so far.
Keywords : Fusarium, Leukemia, Neutropenia, Skin