Update on the treatment of disseminated fusariosis: Focus on voriconazole

Marta Stanzani¹, Fabio Tumietto², Nicola Vianelli¹, Michele Baccarani¹

¹Institute of Haematology and Clinical Oncology “Ariosto e Lorenzo Seràgnoli”, S. Orsola-Malpighi Hospital, University of Bologna, Italy; ²Division of Infectious Diseases, S. Orsola-Malpighi Hospital, University of Bologna, Italy

Abstract: Invasive fungal infections are a major cause of morbidity and mortality in immunocompromised patients, such as subjects with hematological malignancies and patients who underwent to hematopoietic stem cell transplantation (HSCT) or solid organ transplantation (SOT). Fusarium spp. cause a broad spectrum of infections in humans. Immunologically competent hosts show mainly localized skin infections, whereas disseminated fusariosis occurs almost exclusively in immunocompromised patients. Fusarium spp. are resistant to many antifungal agents with equivocal in vitro and in vivo susceptibility to amphotericin B. Voriconazole (VRC) is a triazole shown to be safe, well tolerated, and in vitro efficacious against Fusarium spp. Although clinical experience is limited, many case reports have shown the efficacy of VRC in the treatment of fusariosis.

Keywords: fusariosis, voriconazole, immunocompromised patient, cancer, fungal infections, aspergillus