Fusarium Infections Acquired through: 1. Inhalation of airborne conidia > germinates > blood > disseminated 2. Trauma (implantation with botanical material) > local invasion Often isolated in blood, unlike other hyaline molds: sporulates in vivo, facilitating dissemination and growth in bloodstream. BCx+ in -40% of cases, median -3d after incubation 4 major clinical manifestations of Fusarium infection: - Focal single organ involvement Refractory FUO, Sino-pulmonary, Disseminated disease Therapeutic options for disseminated disease: • Optimal treatment not established, no prospective trials • Most experts recommend lipid formulations of amphotericin B for severe cases; triazole (e.g., voriconazole, posaconazole, isavuconazole) for mild/moderate Tx in setting of endophthalmitis: • Surgical removal of vitreous (vitrectomy) is nearly always necessary • Depending on the type of injury (i.e. open globe), pt might require enucleation Infectious Diseases Fellows Network @ID_fellows #Fusarium #Infections #infectiousdiseases #diagnosis #management
