FUSARIOSIS

Fusarium species are found worldwide in soil and on plants; inhalation, ingestion, and direct inoculation of spores can cause disease, particularly disseminated disease in immunocompromised pts. Fusariosis is angioinvasive and has clinical manifestations similar to those of aspergillosis. One difference is that painful nodular or necrotic skin lesions are extremely common with disseminated fusariosis. Blood cultures are positive in 50% of cases; the organism is difficult to differentiate from Aspergillus in tissue. Fusarium species are often resistant to antifungal agents; liposomal AmB (≥5 mg/kg qd), voriconazole (200–400 mg bid), or posaconazole (300 mg/d) is recommended. Even with treatment, mortality rates are ∼50%.

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