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Case Reports in Medicine
Volume 2013 (2013), Article ID 618358, 4 pages
http://dx.doi.org/10.1155/2013/618358
Case Report

Colonization of a Central Venous Catheter by the Hyaline Fungus Fusarium solani Species Complex: A Case Report and SEM Imaging

1Laboratory of Medical Microbiology, Department of Clinical and Experimental Medicine, University of Insubria and Ospedale di Circolo e Fondazione Macchi, 21100 Varese, Italy
2Laboratory of Human Morphology “L. Cattaneo”, Department of Morphology and Surgery, University of Insubria, 21100 Varese, Italy
3Forensic Institute, Department of Life Sciences, University of Insubria, 21100 Varese, Italy

Received 9 April 2013; Revised 25 May 2013; Accepted 9 June 2013

Academic Editor: Jacques F. Meis

Copyright © 2013 Alberto Colombo et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The incidence of opportunistic infections by filamentous fungi is increasing partly due to the widespread use of central venous catheters (CVC), indwelling medical devices, and antineoplastic/immunosuppressive drugs. The case of a 13-year-old boy under treatment for acute lymphoblastic leukemia is presented. The boy was readmitted to the Pediatric Ward for intermittent fever of unknown origin. Results of blood cultures drawn from peripheral venous sites or through the CVC were compared. CVC-derived bottles (but not those from peripheral veins) yielded hyaline fungi that, based on morphology, were identified as belonging to the Fusarium solani species complex. Gene amplification and direct sequencing of the fungal ITS1 rRNA region and the EF-1alpha gene confirmed the isolate as belonging to the Fusarium solani species complex. Portions of the CVC were analyzed by scanning electron microscopy. Fungi mycelia with long protruding hyphae were seen into the lumen. The firm adhesion of the fungal formation to the inner surface of the catheter was evident. In the absence of systemic infection, catheter removal and prophylactic voriconazole therapy were followed by disappearance of febrile events and recovery. Thus, indwelling catheters are prone to contamination by environmental fungi.