RESUMO
Severely immunocompromised patients are at increased risk for uncommon infectious diseases with atypical presentations. Fusarium sp., has been reported in patients with hematological malignancies and prompt diagnosis is necessary due to high mortality. We report a myelodysplastic syndrome (MDS) patient who presented Fusarium solani infection associated with granulocytic sarcoma as an initial presentation of acute myeloid leukemia (AML) transformation. We performed histological examination, immunohistochemistry analysis, culture of the biopsy tissue and DNA sequencing to make a conclusive diagnosis of F. solani and granulocytic sarcoma, reinforcing the necessity of performing complete evaluation of skin lesions in immunocompromised patients.
Assuntos
Fusariose/diagnóstico , Fusarium/isolamento & purificação , Síndromes Mielodisplásicas/microbiologia , Azacitidina/uso terapêutico , Biópsia , Diagnóstico Diferencial , Feminino , Fusarium/efeitos dos fármacos , Fusarium/genética , Humanos , Hospedeiro Imunocomprometido , Leucemia Mieloide Aguda/complicações , Pessoa de Meia-Idade , Micélio/ultraestrutura , Sarcoma Mieloide/diagnóstico , Sarcoma Mieloide/microbiologia , Sarcoma Mieloide/radioterapia , Análise de Sequência de DNA , Pele/microbiologia , Pele/patologiaRESUMO
In this case report we aimed to present a patient with granulocytic sarcomaa, neutropenic fever, ARDS and Pneumocystis jirovecii pneumoniae that was hospitalized in our intensive care unit. The patient recovered and then developed vancomycin resistant enterococci (VRE) bacteremia due to port catheter during follow up. The patient had risk factors for VRE bacteremia and he was administered linezolide without removing the catheter. He was discharged with recovery.