ECMM-FIMUA epidemiological survey on infections due to Fusarium species in Italy: disseminated proven infections

Fusarium species cause a variety of infections in humans, including superficial, locally invasive, and disseminated infections. The clinical presentation largely depends on the immune status of the host and the fungal portal of entry. The main purpose of this ECMM-FIMUA survey is to understand the epidemiology of fusariosis in Italy collecting information on the patients infected by Fusarium and on the infecting isolates. Cases of fusariosis, for which the infecting isolate is available, have been recorded on a questionnaire and the isolate collected and identified by molecular methods. From August 2007 to October 2010 a total of 15 cases of proven disseminated fusariosis were recorded by five Microbiology Laboratories. The fungus was isolated from blood in 13 patients and from skin biopsy in six. Infection occurred in one patient with liver cancer and in 14 patients with haematological malignancies, (mainly affected by acute myeloid leukaemia) during graft versus host disease (2 patients) and after hematopoietic stem cell transplantation (6 patients). Eight out of 14 patients (57%) died of this fungal infection. One patient was lost to follow up. Fusarium verticillioides and F. proliferatum predominate causing six disseminated infections each and F. solani species complex causes three cases. These data confirm the severity of this fungal infection and the predominance of species other than F. solani as cause of disseminated fusariosis.