Fusarium species
From IDWiki
Microbiology
- Macroscopic: colonies grow rapidly with wooly texture (sometimes mucoid), and white, yellow, pink, purple, or pale brown surface and pale, red, violet, brown, or blue reverse.
- Microscopic: septate hyaline hyphae. Microconidia are unicellular (sometimes bicellular) and hyaline, ovoid to ellipsoid, in chains or singly from denticles. Macroconidia are curved and multicellular, with a foot cell at the base. Chlamydospores may be present.
- The macroconidia are the typical finding used to identify Fusarium spp.
Species that cause disease
- F. solani: most common overall, and a common cause of keratitis
- F. oxysporum: second-most common
- F. verticillioides: third-most common
- F. moniliforme
- F. proliferatum
- F. chlamydosporum
- F. anthophilum
- F. dimerum
- F. sacchari
Epidemiology
- Ubiquitous, common in soil and organic debris, and a common cause of disease in plants.
- In humans, infection is rare and generally occurs after penetrating trauma.
- Disseminated and CNS disease is more common in immunocompromised hosts, including prolonged neutropenia.
Clinical Presentation
- Superficial
- Keratitis and endophthalmitis: big outbreak associated with contact lens solution back in the day
- Onychomycosis
- Skin and musculoskeletal infections (including mycetoma)
- Locally invasive
- Pneumonia
- Peritonitis associated with peritoneal dialysis
- Brain abscess
- Disseminated infection
- Fungemia: can be detected in blood culture
- Disseminated infection
Management
- Remove indwelling lines
- Treat underlying immunocompromise, if possible
- Amphotericin B (high dose) is the antifungal of choice, although vori and posa have also been used
