bloodjourГематология и трансфузиологияRussian journal of hematology and transfusiology0234-57302411-3042ООО Издательский дом «Практика»10.35754/0234-5730-2022-67-1-139-149bloodjour-343Research ArticleКЛИНИЧЕСКИЕ НАБЛЮДЕНИЯCASE REPORTSУспешная диагностика и лечение фузариоза у больной острым лейкозомSuccessful diagnosis and treatment of fusariosis in patient with acute leukemiahttps://orcid.org/0000-0002-3005-2085БатмановаН. А.BatmanovaN. A.

Батманова Наталья Андреевна, кандидат медицинских наук, врач-детский онколог отделения детской онкологии и гематологии (химиотерапии гемобластозов) № 1 НИИ детской онкологии и гематологии 

115478, Москва

Natalia A. Batmanova, Cand. Sci. (Med.), Pediatric Oncologist of the Department of Pediatric Oncology and Hematology (Chemotherapy of Hemoblastosis) No. 1 of the Research Institute of Pediatric Oncology and Hematology 

115478, Moscow

batmanova_nataly@mail.ruhttps://orcid.org/0000-0003-1405-3536БагироваН. С.BagirovaN. S.

Багирова Наталья Сергеевна, доктор медицинских наук, ведущий научный сотрудник микробиологической лаборатории 

115478, Москва

Natalia S. Bagirova, Dr. Sci. (Med.), Leading Researcher of Microbiology Laboratory 

115478, Moscow

nbagirova@mail.ruhttps://orcid.org/0000-0003-4294-1995ГригорьевскаяЗ. В.GrigorievskayaZ. V.

Григорьевская Злата Валерьевна, доктор медицинских наук, заведующая микробиологической лабораторией 

115478, Москва

Zlata V. Grigorjevskaya, Dr. Sci. (Med.), Head of Microbiology Laboratory 

115478, Moscow

zlatadoc@list.ruhttps://orcid.org/0000-0002-1469-2365ВалиевТ. Т.ValievT. T.

Валиев Тимур Теймуразович, доктор медицинских наук, заведующий отделением детской онкологии и гематологии (химиотерапии гемобластозов) № 1 НИИ детской онкологии и гематологии 

115478, Москва

Timur T. Valiev, Dr. Sci. (Med.), Head of the Department of Pediatric Oncology and Hematology (Chemotherapy of Hemoblastosis) No. 1 of the Research Institute of Pediatric Oncology and Hematology 

115478, Moscow

timurvaliev@mail.ruhttps://orcid.org/0000-0001-5911-553XБелышеваТ. С.BelyshevaT. S.

Белышева Татьяна Сергеевна, доктор медицинских наук, ведущий научный сотрудник научно-консультативного отделения НИИ детской онкологии и гематологии 

115478, Москва

Tatyana S. Belysheva, Dr. Sci. (Med.), Leading Researcher of the Scientifi c Advisory Division of the Research Institute of Pediatric Oncology and Hematology 

115478, Moscow

klinderma@mail.ruhttps://orcid.org/0000-0002-2945-284XКиргизовК. И.KirgizovK. I.

Киргизов Кирилл Игоревич, кандидат медицинских наук, заместитель директора по научной и лечебной работе НИИ детской онкологии и гематологии 

115478, Москва

Kirill I. Kirgizov, Cand. Sci. (Med.), Deputy Director for Scientifi c and Educational Work of the Research Institute of Pediatric Oncology and Hematology 

115478, Moscow

kirgiz-off@yandex.ruhttps://orcid.org/0000-0001-6131-1783ВарфоломееваС. Р.VarfolomeevaS. R.

Варфоломеева Светлана Рафаэлевна, доктор медицинских наук, профессор, директор НИИ детской онкологии и гематологии 

115478, Москва

Svetlata R. Varfolomeeva, Dr. Sci. (Med.), Professor, Director of the Research Institute of Pediatric Oncology and Hematology 

115478, Moscow

s.varfolomeeva@ronc.ruФГБУ «Национальный медицинский исследовательский центр онкологии им. Н.Н. Блохина» Министерства здравоохранения Российской ФедерацииРоссияNational Medical Research Center of Oncology named after N.N. Blokhin of the Ministry of Health of RussiaRussian Federation202213042022671139149Copyright © Батманова Н.А., Багирова Н.С., Григорьевская З.В., Валиев Т.Т., Белышева Т.С., Киргизов К.И., Варфоломеева С.Р., 20222022Батманова Н.А., Багирова Н.С., Григорьевская З.В., Валиев Т.Т., Белышева Т.С., Киргизов К.И., Варфоломеева С.Р.Batmanova N.A., Bagirova N.S., Grigorievskaya Z.V., Valiev T.T., Belysheva T.S., Kirgizov K.I., Varfolomeeva S.R.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.htjournal.ru/jour/article/view/343Введение

Введение. Развитие фебрильной нейтропении осложняет течение постхимиотерапевтического периода у многих больных острыми лейкозами, а присоединение инфекционных осложнений может стать причиной жизнеугрожающих состояний. Особенно тяжело протекают инвазивные грибковые инфекции у больных острыми лейкозами в период нейтропении.

Цель работы — представить клиническое наблюдение успешной диагностики и лечения фузариоза у иммунокомпрометированной больной.

Основные сведения

Основные сведения. Представлен мировой и собственный опыт диагностики и лечения редкой грибковой инфекции, вызванной грибами рода Fusarium. Приведено таксономическое многообразие фузарий, освещены морфологические и молекулярные методы диагностики. Отдельное внимание уделено выбору противогрибковой тактики терапии фузариоза. 

Introduction

Introduction. The development of febrile neutropenia complicates the course of the post-chemotherapeutic period in many patients with acute leukemia. Febrile neutropenia — the most common complication of the post-chemotherapeutic period in patients with acute leukemia (AL), and the concomitant infectious complications can cause life-threatening conditions. Invasive fungal infections in AL patients during neutropenia can be extremely severe.

Aim — to present a clinical observation and successful diagnosis and treatment of the rare fungal infection induced by fungi of the genus Fusarium in an immunocompromised patient.

Main findings

Main findings. A clinical observation, diagnosis and treatment of a rare fungal infection caused by the fungi of the Fusarium genus is presented. The taxonomic variety of Fusarium is given, and the morphological and molecular methods of diagnostics are highlighted. Special attention is given to the choice of appropriate antifungal therapy of fusariosis.

острый лейкозинвазивный микозфебрильная нейтропенияфузариоздиагностикалечениеacute leukemiainvasive mycosisfebrile neutropeniafusariosisdiagnosistreatmentthe study had no sponsorship.ReferencesKontoyiannis D.P., Marr K.A., Park B.J., et al. Prospective surveillance for invasive fungal infections in hematopoietic stem cell transplant recipients, 2001–2006: Overview of the Transplant-Associated Infection Surveillance Network (TRANSNET) database. Clin Infect Dis. 2010; 50(8): 1091–100. DOI: 10.1086/651263.Kontoyiannis D.P., Marr K.A., Park B.J., et al. Prospective surveillance for invasive fungal infections in hematopoietic stem cell transplant recipients, 2001–2006: Overview of the Transplant-Associated Infection Surveillance Network (TRANSNET) database. Clin Infect Dis. 2010; 50(8): 1091–100. DOI: 10.1086/651263.Park B.J., Pappas P.G., Wannemuehler K.A., et al. Invasive non-Aspergillus mold infections in transplant recipients, United States, 2001–2006. Emerg Infect Dis. 2011; 17(10): 1855–64. DOI: 10.3201/eid1710.110087.Park B.J., Pappas P.G., Wannemuehler K.A., et al. Invasive non-Aspergillus mold infections in transplant recipients, United States, 2001–2006. Emerg Infect Dis. 2011; 17(10): 1855–64. DOI: 10.3201/eid1710.110087.AlShammasi S., AlNujaidi D., Bakhit K., et al. Successful management of disseminated Fusarium infection in a patient with acute myeloid leukemia. J Hematol Clin Res. 2018; 2: 015–020. DOI: 10.29328/journal.jhcr.1001007.AlShammasi S., AlNujaidi D., Bakhit K., et al. Successful management of disseminated Fusarium infection in a patient with acute myeloid leukemia. J Hematol Clin Res. 2018; 2: 015–020. DOI: 10.29328/journal.jhcr.1001007.Al-Hatmi A.M.S., Bonifaz A., Ranque S., et al. Current antifungal treatment of fusariosis. Int J Antimicrob Agents. 2018; 51(3): 326–32. DOI: 10.1016/j.ijantimicag.2017.06.017.Al-Hatmi A.M.S., Bonifaz A., Ranque S., et al. Current antifungal treatment of fusariosis. Int J Antimicrob Agents. 2018; 51(3): 326–32. DOI: 10.1016/j.ijantimicag.2017.06.017.Hoenigl M., Salmanton-Garcнa J., Walsh T.J., et al. Global guideline for the diagnosis and management of rare mould infections: An initiative of the European Confederation of Medical Mycology in cooperation with the International Society for Human and Animal Mycology and the American Society for Microbiology. Lancet Infect Dis. 2021; 21(8): e246–57. DOI: 10.1016/S1473-3099(20)30784-2.Hoenigl M., Salmanton-Garcнa J., Walsh T.J., et al. Global guideline for the diagnosis and management of rare mould infections: An initiative of the European Confederation of Medical Mycology in cooperation with the International Society for Human and Animal Mycology and the American Society for Microbiology. Lancet Infect Dis. 2021; 21(8): e246–57. DOI: 10.1016/S1473-3099(20)30784-2.Al-Hatmi A.M., Hagen F., Menken S.B.J., et al. Global molecular epidemiology and genetic diversity of Fusarium, a signifi cant emerging human opportunist from 1958 to 2015. Emerg Microbes Infect. 2016; 5(12): e33. DOI: 10.1038/emi.2016.126.Al-Hatmi A.M., Hagen F., Menken S.B.J., et al. Global molecular epidemiology and genetic diversity of Fusarium, a signifi cant emerging human opportunist from 1958 to 2015. Emerg Microbes Infect. 2016; 5(12): e33. DOI: 10.1038/emi.2016.126.Moretti M.L., Busso-Lopes A.F., Tararam C.A., et al. Airborne transmission of invasive fusariosis in patients with hematologic malignancies. PLoS ONE. 2018; 13(4): e0196426. DOI: 10.1371/journal.pone.0196426.Moretti M.L., Busso-Lopes A.F., Tararam C.A., et al. Airborne transmission of invasive fusariosis in patients with hematologic malignancies. PLoS ONE. 2018; 13(4): e0196426. DOI: 10.1371/journal.pone.0196426.Nucci M., Marr K.A., Vehreschild M.J., et al. Improvement in the outcome of invasive fusariosis in the last decade. Clin Microbiol Infect. 2014; 20(6): 580–5. DOI: 10.1111/1469-0691.12409.Nucci M., Marr K.A., Vehreschild M.J., et al. Improvement in the outcome of invasive fusariosis in the last decade. Clin Microbiol Infect. 2014; 20(6): 580–5. DOI: 10.1111/1469-0691.12409.Jain P.K., Gupta V.K., Misra A.K., et al. Current status of Fusarium infection in human and animal. Asian J Anim Vet Adv. 2011; 6(3): 201–27.Jain P.K., Gupta V.K., Misra A.K., et al. Current status of Fusarium infection in human and animal. Asian J Anim Vet Adv. 2011; 6(3): 201–27.Georgiadou S.P., Pongas G., Fitzgerald N.E., et al. Invasive mold infections in pediatric cancer patients refl ect heterogeneity in etiology, presentation, and outcome: A 10-year, single-institution, retrospective study. J Pediatr Infect Dis Soc. 2012; 1(2): 125–35. DOI: 10.1093/jpids/pis042.Georgiadou S.P., Pongas G., Fitzgerald N.E., et al. Invasive mold infections in pediatric cancer patients refl ect heterogeneity in etiology, presentation, and outcome: A 10-year, single-institution, retrospective study. J Pediatr Infect Dis Soc. 2012; 1(2): 125–35. DOI: 10.1093/jpids/pis042.Arnoni M.V., Paula C.R, Aler M.E., et al. Infections caused by Fusarium species in pediatric cancer patients and review of published literature. Mycopathologia. 2018; 183(6): 941–9. DOI: 10.1007/s11046-018-0257-6.Arnoni M.V., Paula C.R, Aler M.E., et al. Infections caused by Fusarium species in pediatric cancer patients and review of published literature. Mycopathologia. 2018; 183(6): 941–9. DOI: 10.1007/s11046-018-0257-6.Sáenz V., Alvarez-Moreno C., Le Pape P., et al. A One Health perspective to recognize Fusarium as important in clinical practice. J Fungi (Basel). 2020; 6(4): 235. DOI: 10.3390/jof6040235.Sáenz V., Alvarez-Moreno C., Le Pape P., et al. A One Health perspective to recognize Fusarium as important in clinical practice. J Fungi (Basel). 2020; 6(4): 235. DOI: 10.3390/jof6040235.Dignani M.C., Anaissie E. Human fusariosis. Clin Microbiol Infect. 2004; 10(Suppl. 1): 67–75. DOI: 10.1111/j.1470-9465.2004.00845.x.Dignani M.C., Anaissie E. Human fusariosis. Clin Microbiol Infect. 2004; 10(Suppl. 1): 67–75. DOI: 10.1111/j.1470-9465.2004.00845.x.Yu J., Chen Y., Fang J., Zhang K. Successful treatment of disseminated fusariosis in a patient with acute lymphoblastic leukemia: A case report and literature review. Medicine (Baltimore). 2019; 98(26): e16246. DOI: 10.1097/MD.0000000000016246.Yu J., Chen Y., Fang J., Zhang K. Successful treatment of disseminated fusariosis in a patient with acute lymphoblastic leukemia: A case report and literature review. Medicine (Baltimore). 2019; 98(26): e16246. DOI: 10.1097/MD.0000000000016246.Torres H.A., Kontoyiannis D.P. Hyalohyphomycoses (Hyaline Moulds). Hyalohyphomycoses (Hyaline Moulds). In: Kauffman C., Pappas P., Sobel J., Dismukes W. (eds) Essentials of Clinical Mycology. Springer, New York, NY; 2011. DOI: 10.1007/978-1-4419-6640-7_16.Torres H.A., Kontoyiannis D.P. Hyalohyphomycoses (Hyaline Moulds). Hyalohyphomycoses (Hyaline Moulds). In: Kauffman C., Pappas P., Sobel J., Dismukes W. (eds) Essentials of Clinical Mycology. Springer, New York, NY; 2011. DOI: 10.1007/978-1-4419-6640-7_16.Nucci M., Anaissie E. Fusarium infections in immunocompromised patients. Clin Microbiol Rev. 2007; 20(4): 695–704. DOI: 10.1128/cmr.00014-07.Nucci M., Anaissie E. Fusarium infections in immunocompromised patients. Clin Microbiol Rev. 2007; 20(4): 695–704. DOI: 10.1128/cmr.00014-07.Al-Hatmi A.M.S., Curfs-Breuker I., de Hoog G.S., et al. Antifungal susceptibility testing of Fusarium: A practical approach. J Fungi. 2017; 3(2): 19. DOI: 10.3390/jof3020019.Al-Hatmi A.M.S., Curfs-Breuker I., de Hoog G.S., et al. Antifungal susceptibility testing of Fusarium: A practical approach. J Fungi. 2017; 3(2): 19. DOI: 10.3390/jof3020019.Al-Hatmi A.M., Meis J.F., de Hoog G.S. Fusarium: Molecular diversity and intrinsic drug resistance. PLoS Pathog. 2016; 12(4): e1005464. DOI: 10.1371/journal.ppat.1005464.Al-Hatmi A.M., Meis J.F., de Hoog G.S. Fusarium: Molecular diversity and intrinsic drug resistance. PLoS Pathog. 2016; 12(4): e1005464. DOI: 10.1371/journal.ppat.1005464.Ruiz-Cendoya M., Pastor J., Guarro J. Combined therapy against murinedisseminated infection by fusarium verticillioides. Mycopathologia. 2011; 171(3): 171–5. DOI: 10.1007/s11046-010-9364-8.Ruiz-Cendoya M., Pastor J., Guarro J. Combined therapy against murinedisseminated infection by fusarium verticillioides. Mycopathologia. 2011; 171(3): 171–5. DOI: 10.1007/s11046-010-9364-8.Martin-Vicente A., Guarro J., Capilla J. Does a triple combination have better activity than double combinations against multiresistant fungi? Experimental in vitro evaluation. Int J Antimicrob Agents. 2017; 49(4): 422–6. DOI: 10.1016/j.ijantimicag.2016.12.015.Martin-Vicente A., Guarro J., Capilla J. Does a triple combination have better activity than double combinations against multiresistant fungi? Experimental in vitro evaluation. Int J Antimicrob Agents. 2017; 49(4): 422–6. DOI: 10.1016/j.ijantimicag.2016.12.015.Venturini T.P., Rossato L., Chassot F., et al. in vitro synergistic combinations of pentamidine, polymyxin B, tigecycline and tobramycin with antifungal agents against Fusarium spp. J Med Microbiol. 2016; 65(8): 770–4. DOI: 10.1099/jmm.0.000301.Venturini T.P., Rossato L., Chassot F., et al. in vitro synergistic combinations of pentamidine, polymyxin B, tigecycline and tobramycin with antifungal agents against Fusarium spp. J Med Microbiol. 2016; 65(8): 770–4. DOI: 10.1099/jmm.0.000301.Batista B.G., Chaves M.A., Reginatto O., et al. Human fusariosis: An emerging infection that is diffi cult to treat. Rev Soc Bras Med Trop. 2020; 53: e20200013. DOI: 10.1590/0037-8682-0013-2020.Batista B.G., Chaves M.A., Reginatto O., et al. Human fusariosis: An emerging infection that is diffi cult to treat. Rev Soc Bras Med Trop. 2020; 53: e20200013. DOI: 10.1590/0037-8682-0013-2020.Tortorano A.M., Prigitano A., Esposto M.C., et al. ESCMID and ECMM joint guidelines on diagnosis and management of hyalohyphomycosis: Fusarium spp., Scedosporium spp. and others. Clin Microbiol Infect. 2014; 20(Supp 3): 27–46. DOI: 10.1111/1469-0691.12465.Tortorano A.M., Prigitano A., Esposto M.C., et al. ESCMID and ECMM joint guidelines on diagnosis and management of hyalohyphomycosis: Fusarium spp., Scedosporium spp. and others. Clin Microbiol Infect. 2014; 20(Supp 3): 27–46. DOI: 10.1111/1469-0691.12465.Groll A.H., Castagnola E., Cesaro S., et al. Fourth European Conference on Infections in Leukaemia (ECIL-4): Guidelines for diagnosis, prevention, and treatment of invasive fungal diseases in paediatric patients with cancer or allogeneic haemopoietic stem-cell transplantation. Lancet Oncol. 2014; 15(8): e327–40. DOI: 10.1016/S1470-2045(14)70017-8.Groll A.H., Castagnola E., Cesaro S., et al. Fourth European Conference on Infections in Leukaemia (ECIL-4): Guidelines for diagnosis, prevention, and treatment of invasive fungal diseases in paediatric patients with cancer or allogeneic haemopoietic stem-cell transplantation. Lancet Oncol. 2014; 15(8): e327–40. DOI: 10.1016/S1470-2045(14)70017-8.Dalyan Cilo B., Al-Hatmi A.M., Seyedmousavi S., et al. Emergence of fusarioses in a university hospital in Turkey during a 20-year period. Eur J Clin Microbiol Infect Dis. 2015; 34(8): 1683–91. DOI: 10.1007/s10096-015-2405-y.Dalyan Cilo B., Al-Hatmi A.M., Seyedmousavi S., et al. Emergence of fusarioses in a university hospital in Turkey during a 20-year period. Eur J Clin Microbiol Infect Dis. 2015; 34(8): 1683–91. DOI: 10.1007/s10096-015-2405-y.Radu L.-E., Colita A., Pasca S., et al. Day 15 and day 33 minimal residual disease assessment for acute lymphoblastic leukemia patients treated according to the BFM ALL IC 2009 protocol: Single-center experience of 133 cases. Front Oncol. 2020; 10: 923. DOI: 10.3389/fonc.2020.00923.Radu L.-E., Colita A., Pasca S., et al. Day 15 and day 33 minimal residual disease assessment for acute lymphoblastic leukemia patients treated according to the BFM ALL IC 2009 protocol: Single-center experience of 133 cases. Front Oncol. 2020; 10: 923. DOI: 10.3389/fonc.2020.00923.Артамонова Е.В., Архири П.П., Базин И.С. и др. Руководство по химиотерапии опухолевых заболеваний. Под ред. Н.И. Переводчиковой, В.А. Горбуновой. М.: Практическая медицина; 2015.Artamonova E.V., Archiri P.P., Bazin I.S., et al. Guidelines for chemotherapy of tumor diseases. Eds. N.I. Perevodchikova, V.A. Gorbunova. Moscow: Prakticheskaya medicina Publ.; 2015. (In Russian).

The authors declare that there are no conflicts of interest present.