Excerpt from
THE JOHNS HOPKINS MICROBIOLOGY NEWSLETTER Vol. 26, No. 05
Tuesday, March 6, 2007
Organism:
Fusarium is a filamentous fungus widely distributed on plants, in the soil and in water. It is a transient component of aeroflora and is a common contaminant of commodities such as rice, bean and soybean. Currently, there are over 20 known species of Fusarium, with only some causing infections in humans. Notably, Fusarium is an emerging cause of opportunistic mycoses.
Treatment:
Fusarium is one of the most drug resistant fungi. In particular, Fusarium solani is the most drug resistant of all. Fusarium has high MICs for many antifungal agents (flucytosine, ketoconazole, miconazole, fluconazole, itraconazole and posaconazole) and is intrinsically resistant to the glucan synthesis inhibitors caspofungin, anidulafungin, and micafungin. Amphotericin B, voriconazole, and natamycin have low MICs. Voriconazole and posaconazole are effective choices for Fusarium. Amphotericin B, particularly lipid formulations, alone or with flucytosine or rifampin is commonly used for fusariosis. For localized Fusarium infections, antifungal therapy should be preceded by surgical debridement. For optimal therapy, fungal susceptibility should be determined and the antifungal agent should be administered at the highest tolerable doses. Unfortunately, Fusarium is difficult to treat and invasive forms are often fatal.
