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Epidemiology and Outcome of Human Fusariosis as reflected in published cases of the disease


Schmidig, Doris. Epidemiology and Outcome of Human Fusariosis as reflected in published cases of the disease. 2013, University of Zurich, Faculty of Medicine.

Abstract

Background: Fusarium is a mold mainly known as plant and animal pathogen. Recently, there has been an increasing number of reports about fusarium infection in humans, especially as opportunistic infection in immunocompromised patients with a significant morbitiy and mortality rate. The aim of this study is to further elucidate the behavior of fusariosis in humans. Methods: We analyzed all reports of Fusarium infection in the English and German literature from 1958 to 2007. Data about the age, gender, underlying condition, symptoms, Fusarium species, treatment and outcome were analyzed. Results: 213 cases with either histologically or culture proven infection were included. 62.5% (n=133) were male. The median age of the patients was 39.9 years (range: 0.04-82 years). The overall mortality rate was 34.7% (n=74), with a direct correlation between the underlying condition, the immune status of the patient and the site of infection. No underlying condition was found in only 4.2% (n=9) of all cases. All of them survived and none of them had a disseminated disease. A disseminated infection was detected in 40% (n=86) of all analyzed cases with fusariosis. The second leading site of Fusarium infection was the skin 22.5% (n=48) and eye 15% (n=33). Fusarium solani was the most frequent species. 92.5% (n=197) of all patients received antifungal therapy. The most frequent used antifungal agent was amphotericin B deoxycholate and its liposomal equivalent. Only 6 patients received no treatment at all, neither surgery nor any sort of medication. 4 of them died. Conclusion: From the first case in 1958 an increasing number of cases were published each decade with a peak between 1990-1999. The outcome depends on the site of infection and the immune status of the patient. Disseminated Fusariosis in immunocompromised patients had a very poor outcome. Usually a recovery is achieved as soon as the immune status of the patient improves.

Background: Fusarium is a mold mainly known as plant and animal pathogen. Recently, there has been an increasing number of reports about fusarium infection in humans, especially as opportunistic infection in immunocompromised patients with a significant morbitiy and mortality rate. The aim of this study is to further elucidate the behavior of fusariosis in humans. Methods: We analyzed all reports of Fusarium infection in the English and German literature from 1958 to 2007. Data about the age, gender, underlying condition, symptoms, Fusarium species, treatment and outcome were analyzed. Results: 213 cases with either histologically or culture proven infection were included. 62.5% (n=133) were male. The median age of the patients was 39.9 years (range: 0.04-82 years). The overall mortality rate was 34.7% (n=74), with a direct correlation between the underlying condition, the immune status of the patient and the site of infection. No underlying condition was found in only 4.2% (n=9) of all cases. All of them survived and none of them had a disseminated disease. A disseminated infection was detected in 40% (n=86) of all analyzed cases with fusariosis. The second leading site of Fusarium infection was the skin 22.5% (n=48) and eye 15% (n=33). Fusarium solani was the most frequent species. 92.5% (n=197) of all patients received antifungal therapy. The most frequent used antifungal agent was amphotericin B deoxycholate and its liposomal equivalent. Only 6 patients received no treatment at all, neither surgery nor any sort of medication. 4 of them died. Conclusion: From the first case in 1958 an increasing number of cases were published each decade with a peak between 1990-1999. The outcome depends on the site of infection and the immune status of the patient. Disseminated Fusariosis in immunocompromised patients had a very poor outcome. Usually a recovery is achieved as soon as the immune status of the patient improves.

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Additional indexing

Item Type:Dissertation
Referees:Imhof Alexander, Battegay Edouard
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic and Policlinic for Internal Medicine
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2013
Deposited On:05 Feb 2013 11:37
Last Modified:05 Apr 2016 16:28
Permanent URL: https://doi.org/10.5167/uzh-73145

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