Johns Hopkins ABX GuidePathogensFungi

Fusarium

Shmuel Shoham, M.D., Aimee Zaas, M.D.
Fusarium is a topic covered in the Johns Hopkins ABX Guide.

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MICROBIOLOGY

  • Filamentous fungi ubiquitous in environment.
    • Fusarium species most often found in association with soil and vegetation, especially around roots.
    • Contamination of hospital water systems reported as a potential risk in some immunocompromised patients.
    • Contamination/infection of wheat, corn and other foodstuffs is a major agricultural challenge causing damage to crops and toxin-mediated disease in humans and animals.
  • There are hundreds of species within the Fusarium genus, approximately 70 of which have been associated with human and animal infection. Clinically important species are grouped as complexes, each of which is composed of many species
    • Species with potential to cause invasive infections:
      • Fusarium solani complex: ~50% of cases
      • F. oxysporum complex: ~20% of cases
      • F. fujikuroi complex: ~10% of cases and includes the species
        • F. verticillioides (formerly F. moniliforme): associated with rotting corn and can cause invasive human infections.
      • Other complexes:
        • F. incarnatum-equiseti 
        • F. dimerum 
        • F. chlamydosporum  
    • Multiple Fusarium species have the potential to cause toxin-mediated disease in humans and animals due to poisoning from mycotoxins such as fumonisins and trichothecenes that contaminate agricultural products like wheat, corn and other cereals (e.g. F. sporotrichioides, F. avenaceum, F. graminearum, F. culmorum, F. poae, F. verticillioides).
  • Appearance in tissue:
    • Nonpigmented (hyaline), septated hyphae (3-8 µm in diameter) with acute and right angle branching.
      • Typical appearance, Fig 1
      • May be impossible to distinguish from Aspergillusin tissue
    • Yeast-like structures (called adventitious spores or aleuroconidia) may also be present in tissue. The combination of hyphae and aleuroconidia in tissue is highly suggestive of fusariosis.
  • Appearance in culture: Canoe-shaped multicellular conidia (spores) are characteristic.
    • Blood cultures: Unlike almost all other filamentous fungi, blood cultures may be positive with fusariosis (typically in immunocompromised patients and central vascular catheter infections).

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Last updated: January 3, 2017