Fatal Disseminated Infection with Fusarium petroliphilum Tuba Ersal • Abdullah S. M. Al-Hatmi • Burcu Dalyan Cilo • Ilse Curfs-Breuker • Jacques F. Meis • Fahir O ¨ zkalemkas¸ • Beyza Ener • Anne D. van Diepeningen Received: 19 June 2014 / Accepted: 10 September 2014 / Published online: 19 September 2014 Ó Springer Science+Business Media Dordrecht 2014 Abstract Members of the Fusarium solani species complex (FSSC) are causing the majority of the fusariosis in humans. Disseminated fusariosis has a high mortality and is predominantly observed in patients with leukemia. Here, we present the case of a fatal infection by a Fusarium strain with a degenerated phenotype, in a patient with acute lymphatic leukemia. Multiple nasal and skin biopsies as well as blood cultures yielded fungal growth, while in direct and histopathological examination of biopsy material sep- tate hyphae were visible. Initial colonies were white with slimy masses with microconidia reminiscent of Fusarium/Acremonium, but with conidiospore produc- tion directly on the hyphae. Multi-locus sequence typing discerned a pionnotal—morphologically degen- erated—colony of the recently recognized F. petrol- iphilum as etiological agent. The culture returned to a typical F. solani species complex morphology only after several weeks of growth in culture. Antifungal susceptibility tests indicate amphotericin B as best drug for this FSSC member rather than any of the azoles or echinocandins. Keywords Acute leukemia Á Antifungal susceptibility tests Á Fusarium petroliphilum Á Fusarium solani species complex Á Pionnotal cultures Introduction The types of infection caused by Fusarium spp. in humans range from infections of nail, skin, and eye in immuno- competent hosts to invasive and disseminated infections in mainly immunocompromised patients [1–3]. In particular, the different types of leukemic patients are vulnerable to disseminated infections. For disseminated fusariosis, prolonged neutropenia and T cell immunodeficiency are two of the main risk factors [1]. Disseminated fusariosis is often fatal and presents with characteristic skin lesions with necrotic center and positive blood cultures. At least six species complexes and several single species with the large genus Fusarium have been T. Ersal Á F. O ¨ zkalemkas¸ Department of Haematology, Faculty of Medicine, Uludag˘ University, Bursa, Turkey A. S. M. Al-Hatmi Á A. D. van Diepeningen (&) CBS-KNAW Fungal Biodiversity Centre, Uppsalalaan 8, 3584 CT Utrecht, The Netherlands e-mail: a.diepeningen@cbs.knaw.nl B. Dalyan Cilo Á B. Ener Department of Medical Microbiology, Faculty of Medicine, Uludag˘ University, Bursa, Turkey I. Curfs-Breuker Á J. F. Meis Department of Medical Microbiology and Infectious Diseases, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands J. F. Meis Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, The Netherlands 123 Mycopathologia (2015) 179:119–124 DOI 10.1007/s11046-014-9813-x