AI Article Synopsis
- Cellulitis is typically a bacterial infection treated with antibiotics, but immunocompromised patients may develop fungal cellulitis, which can be mistaken for bacterial infections and complicate treatment outcomes.
- The text discusses three cases of fungal cellulitis in immunosuppressed individuals where initial treatments for suspected bacterial infections failed, highlighting the importance of recognizing atypical symptoms.
- Recognizing fungal pathogens like Fusarium solani and Purpureocillium lilacinum is crucial for proper diagnosis and treatment, especially when infections do not respond to standard antibiotic therapies.
Article Abstract
Background: Cellulitis is an infection most commonly caused by bacteria and successfully treated with antibiotics. However, certain patient populations, especially the immunocompromised, are at risk for fungal cellulitis, which can be misidentified as bacterial cellulitis and contribute to significant morbidity and mortality.
Case Presentations: We describe three cases of opportunistic fungal cellulitis in immunosuppressed patients that were initially mistaken for bacterial infections refractory to antibiotic therapy. However, atypical features of cellulitis ultimately prompted further diagnostics to identify fungal cellulitis and allow initiation of appropriate antifungals. We discuss: (1) a 52-year-old male immunosuppressed hematopoietic cell transplant recipient with Fusarium solani cellulitis on his right lower extremity that was treated with amphotericin B and voriconazole with full resolution of the cellulitis; (2) a 70-year-old male lung transplant recipient with Fusarium solani cellulitis on his left lower extremity that ultimately progressed despite antifungals; and (3) a 68-year-old male with a history of kidney transplantation with suspected Purpureocillium lilacinum cellulitis on his left lower extremity ultimately treated with posaconazole with resolution of the skin lesions.
Conclusions: Fusarium solani and Purpureocillium lilacinum are important pathogens causing opportunistic fungal cellulitis. These cases remind providers to be vigilant for fungal cellulitis when skin and soft tissue infection does not adequately respond to antibiotics and atypical features of cellulitis are present.
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|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9074255 | PMC |
| http://dx.doi.org/10.1186/s12879-022-07365-8 | DOI Listing |
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