Fusarium species

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Fusarium /
Revision as of 01:18, 21 July 2020 by Aidan (talk | contribs) (Text replacement - "Clinical Presentation" to "Clinical Manifestations")

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 Manifestations

  • 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