Fusariosis

Fusariosis is an opportunistic fungal infection caused by species of the genus Fusarium, most commonly Fusarium solani, Fusarium oxysporum, and Fusarium verticillioides. It is classified as a rare invasive mycosis that primarily affects immunocompromised individuals, particularly those with prolonged and severe neutropenia (such as patients undergoing chemotherapy for hematologic malignancies or hematopoietic stem cell transplant recipients), as well as patients receiving corticosteroid therapy or those with aplastic anemia. In immunocompetent individuals, Fusarium infections are typically localized, most often presenting as keratitis (corneal infection) following ocular trauma or onychomycosis (nail infection). In immunocompromised patients, fusariosis can become disseminated and life-threatening. The infection can affect multiple body systems including the skin, lungs, sinuses, eyes, and bloodstream. Key clinical features include persistent fever unresponsive to broad-spectrum antibiotics, skin lesions (often painful erythematous papules or nodules with central necrosis resembling ecthyma gangrenosum), pneumonia, sinusitis, and fungemia (positive blood cultures, which distinguishes Fusarium from many other mold infections such as aspergillosis). Disseminated disease carries a very high mortality rate, particularly in patients with persistent neutropenia. Treatment of fusariosis is challenging because Fusarium species are intrinsically resistant to many antifungal agents. The primary antifungal agents used include voriconazole and amphotericin B (particularly lipid formulations), often in combination. Recovery of the host immune system, especially resolution of neutropenia, is critical for successful treatment outcomes. Adjunctive therapies such as granulocyte colony-stimulating factor (G-CSF) or granulocyte transfusions may be considered. Surgical debridement of localized infections can also be beneficial. Despite treatment, prognosis remains poor in patients with persistent immunosuppression, with mortality rates exceeding 50-70% in disseminated disease.

Data sourced from FDA regulatory filings and ClinicalTrials.gov. Updated periodically.

Common questions about Fusariosis