Fungemia Due to the Fusarium solani Species Complex in Coinfection with Aspergillus terreus After Haploidentical Hematopoietic Stem Cell Transplantation for Severe Aplastic Anemia
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Abstract
Invasive fungal infections (IFIs) represent an important cause of morbidity and mortality in patients undergoing hematopoietic stem cell transplantation (HSCT), particularly in the setting of profound and prolonged immunosuppression. Among the emerging etiological agents, filamentous fungi, especially Aspergillus spp. and Fusarium spp., stand out, and although coinfection is rare, it poses a significant diagnostic and therapeutic challenge. We report the first known case of coinfection by Aspergillus terreus and the Fusarium solani species complex in a patient with severe aplastic anemia who underwent haploidentical HSCT. The patient developed a clinical presentation consistent with disseminated fungal infection, characterized by Fusarium fungemia and necrotic skin lesions, despite combined antifungal therapy. Graft failure and prolonged neutropenia were the main determinants of the unfavorable outcome. This case highlights the complexity and severity of invasive fungal coinfections in immunocompromised hosts, emphasizing the need for rigorous microbiological surveillance, early diagnosis, and new integrated therapeutic approaches coupled with effective immune recovery.
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