2011, Number 4
Rev Hematol Mex 2011; 12 (4)
Hernández-Cruz C, Núñez-Quintana A, Rodríguez-Fraga Y, Carnot-Uria J, Muñío-Perurena J, Pérez-Román G, Chávez-Medina R, Moya-Pérez I, Llanes-Rodríguez N, Hart-Casares M
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ABSTRACTThe fungal infections in the immunocompromised population is a medical problem which has been raising during recent decades. The emergence of less common, but medically important fungi has increased, such as Fusarium sp. The first two cases in Cuba of disseminated infection are reported, both in patients with acute leukemias. The first one was a patient with a new onset acute lymphoblastic leukemia (ALL), and the other one was a case of monocytic (M5) acute myeloblastic leukemia, in his second complete remission, who underwent a bone marrow transplantation. Both cases developed the infection during the severe neutropenic period, starting with cellulitis on feet, and after that suffered necrotic lesions on skin and subcutaneous nodules. The ALL case was managed with conventional Amphotericin B formulation, liposomal Amphotericin B and Fluconazole that were administered in a sequential schedule; by that time the neutrophil count improved and the patient achieved his cure. The second case had a fatal outcome ten days after transplantation due to respiratory failure and in severe neutropenia. A brief review of the literature for Fusarium sp infection was carried out. The clinical features, the difficulties in the treatment and the poor prognosis of the patients in the setting of severe and prolonged neutropenia were confirmed.