Cutaneous Fusariosis in a Pediatric Patient With Leukemia: A Diagnostic and Therapeutic Challenge

TL;DR

A child with leukemia developed a rare fungal infection called fusariosis, which was difficult to diagnose and treat, leading to a fatal outcome.

Contribution

This case study highlights the diagnostic and therapeutic challenges of fusariosis in immunocompromised pediatric patients.

Findings

Cutaneous lesions in fusariosis can progress rapidly to necrotic plaques in immunocompromised patients.

Delayed diagnosis and treatment of fusariosis can lead to septic shock and death.

Multidisciplinary management is crucial for improving outcomes in pediatric fusariosis cases.

Abstract

Fusariosis is a rare opportunistic fungal infection that primarily affects immunocompromised patients. Due to its nonspecific initial clinical manifestations, diagnosis is often delayed, which has a negative impact on patient outcomes. We report the case of an eight-year-old male patient with relapsed acute B-cell lymphoblastic leukemia and central nervous system involvement who developed fever and neutropenia during chemotherapy. Even though treatment with broad-spectrum antibiotic therapy was initiated, the patient developed disseminated cutaneous lesions characterized by erythematous macules that later progressed to necrotic plaques. Antifungal therapy with amphotericin B and voriconazole was established, but the patient’s clinical condition deteriorated rapidly, resulting in septic shock and a fatal outcome. Histopathological examination and fungal cultures confirmed the diagnosis of invasive fusariosis. This case highlights the importance of early recognition of cutaneous manifestations of fusariosis in immunocompromised pediatric patients and emphasizes the need for multidisciplinary management to improve clinical outcomes.

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