#IdBoardReview 60 M AML on chemo, neutropenic w/ sepsis, BC neg, on vanc/cefepime: clinically worse. +skin lesion, biopsy shown. diagnosis? #medEd #IDmedEd 
#Fusarium most commonly in pts with acute leukemia & profound neutropenia >3 wks. Also seen in HSCT pts, portal of entry unknown ?inhalation, ingestion, skin trauma. hematogenous spread w/ indwelling catheters
#fusarium skin lesions 60%-80% cases as multiple papule or painful nodules & later become raised, erythematous, necrotic. common on extremities but can be seen on trunk/face. +BC in 50%, septate hyphae have both acute & right angle branching
#fusarium mortality 50%-80%. survival associated w/recovery from neutropenia. steroids can impair response to tx. removal of catheter associated w/ improvement. voriconazole or amphotericin B for deep skin infections. Natamycin 5%opthalmic for keratitis.
