Breakthrough Invasive Fusarium Orbital Rhinosinusitis With Meningitis

Abstract

A patient around 70 years of age with a history of relapsed acute myeloid leukemia and previously treated pulmonary aspergillosis receiving voriconazole prophylaxis was admitted for initiation of induction therapy before proceeding with allogeneic stem cell transplantation. Because of drug interactions and QTc prolongation, voriconazole was transitioned to isavuconazole prophylaxis on admission. On day 13 of chemotherapy, the patient became hypotensive and febrile to 38.5° C, and acute left eye and facial pain with sinus congestion developed.