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Volume 27, Number 1—January 2021
CME ACTIVITY - Synopsis

Invasive Fusariosis in Nonneutropenic Patients, Spain, 2000–2015

Elena Pérez-Nadales, Ana Alastruey-Izquierdo, María José Linares-Sicilia, Juan Carlos Soto-Debrán, Edson Abdala, Julio García-Rodríguez, Miguel Montejo, Patricia Muñoz, Miguel Salavert Lletí, Antonio Rezusta, Maite Ruiz Pérez de Pipaón, Lucrecia Yáñez, Esperanza Merino, María Isolina Campos-Herrero, José María Costa-Mateo, Jesús Fortún, Tomás García-Lozano, Carolina Garcia-Vidal, Mario Fernández-Ruiz, Ferrán Sánchez-Reus, Carmen Castro-Méndez, Inmaculada Guerrero-Lozano, Pere Soler-Palacín, José María Aguado, Luis Martínez-Martínez, Julian Torre-Cisneros1Comments to Author , Marcio Nucci1, and the Spanish Fusariosis Study Group2
Author affiliations: Spanish Network for Research in Infectious Diseases, Instituto de Salud Carlos III, Madrid, Spain (E. Pérez-Nadales, A. Alastruey-Izquierdo, M. Montejo, M. Ruiz Pérez de Pipaón, L. Yáñez, J. Fortún, C. Garcia-Vidal, M. Fernández-Ruiz, I. Guerrero-Lozano, P. Soler-Palacín, J.M. Aguado, L. Martínez-Martínez, J. Torre-Cisneros); Maimonides Biomedical Research Institute of Cordoba, Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain (E. Perez-Nadales, M.J. Linares Sicilia, J. M. Costa-Mateo, L. Martínez-Martínez, J. Torre-Cisneros); Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid, Spain (A. Alastruey-Izquierdo, J.C. Soto-Debrán); Hospital das Clinicas, Universidade de São Paulo, São Paulo, Brazil (E. Abdala); Hospital Universitario La Paz, Madrid (J. García-Rodríguez); Hospital Universitario Cruces, Baracaldo, Spain (M. Montejo); Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Hospital Gregorio Marañón, Universidad Complutense de Madrid, Madrid, Spain (P. Muñoz); Hospital Universitario "12 de Octubre," Instituto de Investigación Hospital "12 de Octubre,” Universidad Complutense, Madrid, Spain (M. Fernández-Ruiz, J.M. Aguado); Hospital Universitario y Politécnico La Fe, Valencia, Spain (M. Salavert Lletí); Hospital Universitario Miguel Servet, Universidad de Zaragoza, Instituto de Investigación Sanitaria Aragón, Zaragoza, Spain (A. Rezusta); Hospital Universitario Virgen del Rocío, Seville, Spain (M. Ruiz Pérez de Pipaón); Hospital Universitario Marqués de Valdecilla, Instituto de Investigación Sanitaria Valdecilla, Santander, Spain (L. Yáñez); Hospital General Universitario de Alicante, Spain (E. Merino); Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, Spain (M. I. Campos-Herrero); Hospital Ramón y Cajal, Madrid (J. Fortún); Fundación Instituto Valenciano de Oncología, Valencia, Spain (T. García-Lozano); Hospital Universitario de Bellvitge, Barcelona, Spain (C. Garcia-Vidal); Hospital de la Santa Creu i Sant Pau, Barcelona (F. Sánchez-Reus); Hospital Universitario Virgen de Valme, Seville (C. Castro-Méndez); Hospital Universitario Puerta del Mar, Cádiz, Spain (I. Guerrero-Lozano); Hospital Universitari Vall d’Hebron, Barcelona (P. Soler-Palacín); Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil (M. Nucci)

Main Article

Table 1

Clinical characteristics of patients with invasive fusariosis, Spain, 2000–2015*

Variables Total Nonneutropenic Neutropenic p value†
Total
 58 (100.0)
 14 (100.0)
 44 (100.0)
Sex
M 34 (58.6) 8 (57.1) 26 (59.1) 0.9
F
 24 (41.4)
 6 (42.9)
 18 (40.9)
 0.9
Median age, y (IQR)
 51 (31–67)
 67 (38–79)
 45 (28–65)
 0.05‡
Treatment history (previous 30 d)
Antifungal 37 (63.8) 5 (35.7) 32 (72.7) 0.01
Corticosteroid 22 (37.9) 6 (42.9) 16 (36.4) 0.66
Persistent neutropenia
 23 (39.7)
 0
 23 (52.3)
Concurrent conditions
Hematologic malignancy 46 (79.3) 5 (35.7) 41 (93.2) <0.01§
Acute myeloid leukemia 20 (34.5) 1 (7.1) 19 (43.2)
Acute lymphoid leukemia 8 (13.8) 0 8 (18.2)
Non-Hodgkin lymphoma 5 (8.6) 2 (14.3) 3 (6.8)
Aplastic anemia 4 (6.9) 0 4 (9.1)
Multiple myeloma 3 (5.2) 2 (14.3) 1 (2.3)
Myelodysplasia 2 (3.4) 0 2 (4.5)
Chronic lymphoid leukemia 2 (3.4) 0 2 (4.5)
Chronic myeloid leukemia 1 (1.7) 0 1 (2.3)
Hodgkin´s lymphoma 1 (1.7) 0 1 (2.3)
History of hematopoietic stem cell transplant 14 (24.1) 3 (21.4) 11 (25.0) 1.00§
Allogenic 9 (15.5) 1 (7.1) 8 (18.2)
Autologous 4 (6.9) 2 (14.3) 2 (4.5)
Cord blood haploidentical 1 (1.7) 0 1 (2.3)
Graft-versus-host disease 5 (8.6) 1 (7.1) 4 (9.1) 1.00§
    Acute 3 (5.2) 0 3 (6.8)
    Chronic 2 (3.4) 1 (7.1) 1 (2.3)
Solid tumor 2 (3.4) 1 (7.1) 1 (2.3) 0.43§
History of solid organ transplant 4 (6.9) 3 (21.4) 1 (2.3) 0.04§
Other¶
 10 (17.2)
 5 (35.7)
 1 (2.3)
 <0.01§
Clinical manifestations
Fever 48 (82.8) 8 (57.1) 40 (90.9) <0.01§
Skin lesions 32 (55.2) 3 (21.4) 29 (65.9) <0.01
Lung involvement 41 (70.7) 9 (64.3) 32 (72.7) 0.74§
Sinusitis 9 (15.5) 1 (7.1) 8 (18.2) 0.43§
Blindness
 4 (6.9)
 0
 4 (9.1)
 0.56§
Concurrent infection 31 (53.4) 6 (42.9) 25 (56.8) 0.36
Bacterial 17 (29.3) 2 (14.3) 15 (34.1) 0.18§
Fungal 4 (6.9) 1 (7.1) 4 (9.1) 0.56§
Viral 6 (10.3) 3 (21.4) 3 (6.8) 0.15§
Polymicrobial
 4 (6.9)
 1 (7.1)
 3 (6.8)
 1.00§
Type of fusariosis
Localized 19 (32.8) 10 (71.4) 9 (20.5) <0.01§
Cutaneous, localized 3 (5.2) 1 (7.1) 2 (4.5) 1.00§
Pneumonia 8 (13.8) 5 (35.7) 3 (6.8) 0.02§
Sinusitis 1 (1.7) 0 1 (2.3) 1.00§
Fungemia 7 (12.1) 4 (28.6) 3 (6.8) 0.05§
Disseminated
 39 (67.2)
 4 (28.6)
 35 (79.5)
 <0.01§
Diagnosis
Culture 31 (53.4) 12 (85.7) 19 (43.2) <0.01
Culture and histopathology 25 (43.1) 2 (14.3) 23 (52.3) 0.01
Histopathology 2 (3.4) 0 2 (4.5) 1.00

*Values are no. (%), except where indicated.
†p values obtained by χ2 test, except where indicated. 
‡Determined by Mann-Whitney U test. 
§Determined by Fisher exact test. 
¶Other conditions reported include hemophagocytic lymphohistiocytosis, chronic cardiac disease, T-cell prolymphocytic leukemia, rheumatoid arthritis, chronic obstructive pulmonary disease, and infantile respiratory distress syndrome.

Main Article

1These senior authors contributed equally to this article.

2Members are listed at the end of this article.

Page created: December 23, 2020
Page updated: December 23, 2020
Page reviewed: December 23, 2020
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