Fusariosis: an update on therapeutic options for management

Abstract

ABSTRACT Introduction Disseminated fusariosis is a serious fungal infection with a high mortality rate among immunocompromised hosts. Management of fusariosis is challenging due to intrinsic resistance to most available antifungal agents. The novel antifungals that are in the pipeline may help to enhance favorable outcome of fusariosis. Clinical trials and animal model studies are required to achieve optimal management of fusariosis. Areas covered This review highlights the available and novel antifungal agents for management of human fusariosis. It also highlights the importance of surgical debridement and reversal of immunosuppression in patients with invasive fusariosis We examine the following databases: Medline, PubMed, and Google Scholar for the following key terms ‘fusariosis', ‘disseminated fusariosis,’ ‘invasive fusariosis,’ and ‘Fusarium.’ Expert opinion Currently, voriconazole or liposomal amphotericin B is the recommended approach for treating invasive fusariosis. Posaconazole is used for salvage therapy. Combination therapy may be used in refractory or severe cases as empiric therapy awaiting results of susceptibility testing. Granulocyte colony stimulating factor is usually used in patients with profound and prolonged neutropenia. Immunosuppressive agents should be reduced when possible. Primary triazole prophylaxis may be considered for high-risk patients, while secondary prophylaxis is recommended in patients with a history of invasive fusariosis requiring immunosuppression.