Journal of Hospital Infection (1997) 36, 223-228 Fungaemia due to Fusarium spp. in cancer patients V. Krcmery Jr& Z. Jesenskat, S. Spanik$, J. Gyarfas”, J. Nogova”, R. Botek$, J. Mardiak*, J- Sufliarsky*, J. Sisolakova, M. Vanickova§, A. Kunova *, M. Studena$ and J. Trupl” “Department f o Microbiology, Medicine, Chemotherapy and Haematology, National Cancer Institute, Bratislava, fNationa1 Reference Laboratory for Mycoses-Research Institute of Preventive and Clinical Medicine, Bratislava, $Department of Medicine, University of Tvnava, SDepartment of Pharmacology, St Elizabeth’s Cancer Institute Bratislava and Tmava, Slovak Republic Received 22 October 1966; revised manuscript accepted 26 March 1997 Summary: Five cases of fungaemia due to Fusarium spp. in cancer patients are described. Two were breakthrough cases, despite ongoing therapy with amphotericin B. Three were caused by Fusarium solani, one by F. oxysporum and one by F. dimerum. Four patients died, three of them despite therapy with amphotericin B for between 5-37 days. We describe only the second reported case of F. dimerum fungaemia. Since 1972, 93 cases of systemic infection with Fusarium spp. have been described: 43 had positive blood cultures and the overall mortality was 72%. Keywords: Fusarium spp; fungaemia; cancer patient. Introduction Fusarium spp. are common soil organisms and plant pathogens. They have long been recognized as causing localized infections of the skin.lm3 The first systemic infection was described 24 years ago in a leukaemic child4 and since then, 88 cases have been described. Localized deep Fusarium infections are rare. Disseminated Fusarium infection is almost exclusively encountered in immunocompromised individuals, particularly in neutropenic cancer patients. Up to 1990, only sporadic cases had been described, but in the last five years the incidence of the infection seems to have increased. Fever, positive blood cultures, myalgias, skin lesions and multiple-organ-system involvement are distinctive features in most cases of disseminated fusariosis. The prognosis is very poor, with death generally following despite anti- fungal therapy, especially with associated fungaemia. All available anti- fungal drugs show low activity against the various species. Amphotericin Correspondence to: Professor V. Krcmery, University of Tmava, Dept of Medicine, Hornopotocna 43, 917 43 Tmava, Slovak Republic. 0195-6701/97/070223+06 9112.00/O 223 Q 1997 The Hospital Infection Soc~ty