Invasive Fungal Rhinosinusitis by Fusarium proliferatum/annulatum in a Patient with Acute Myeloid Leukemia: A Case Report and Review of the Literature

Antifungal prophylaxis with a mold-effective agent has led to a substantial decrease in invasive infections caused by Aspergillus spp. in the management of patients with acute myeloid leukemia undergoing induction chemotherapy. However, difficult-to-treat infections caused by other molds, such as Fusarium, Lomentospora, and Scedosporium species may still complicate the neutropenic period. Here, we present a case of a 23-year-old woman with acute myeloid leukemia who developed a breakthrough invasive fungal rhinosinusitis caused by Fusarium proliferatum/annulatum on posaconazole prophylaxis. The infection was diagnosed using clinical, microbiological, and radiological criteria and the isolate was identified using Matrix Assisted Lazer Desorption Ionization Time of Flight Mass Spectrometry (MALDI-TOF MS) and sequencing. We searched Pubmed with “Fusarium proliferatum”, “Fusarium annulatum”, “immunosuppression AND fusariosis“, “rhinosinusitis AND Fusarium proliferatum” and summarized the English literature for similar rhinosinusitis cases infected with the same pathogen.