Successful treatment of disseminated fusariosis in a child with acute myelogenous leukaemia with medical and surgical approach

We report a case of disseminated fusariosis in an 8-year-old boy with acute myelogenous leukaemia that occurred whilst the patient was severely neutropenic after high-dose chemotherapy. Lung involvement was associated with recurrent typical skin lesions. Despite a significant clinical and radiological improvement with voriconazole-based antifungal therapy, granulocyte transfusions (GTXs) and surgical excision of residual lesions were necessary to achieve a complete response before the patient proceeded to allogeneic stem-cell transplantation from an alternative donor. Voriconazole was continued for 6 months after transplant as secondary prophylaxis. After 15 months of follow-up, the patient is alive and well, and in complete remission of his underlying disease. Triazoles have the potential for improving the cure rate of Fusarium infections but both surgery and shortening the duration of neutropenia by GTXs are important factors in optimising the results.