Disseminated Fungal Infection in Profoundly Immunocompromised Hosts: A Three-Case Series
Abstract
Disseminated fungal infection (DFI) is uncommon in the general population but represents a severe and frequently fatal complication in immunocompromised patients, particularly those with hematologic malignancies and prolonged neutropenia. In high-risk settings, invasive fungal infections occur with clinically meaningful frequency; a large systematic review of critically ill patients reported a pooled prevalence of invasive fungal infection of approximately 5%, highlighting that while DFI is uncommon in the general population, serious fungal disease is encountered more frequently in select high-risk cohorts. We report a case series of three immunocompromised patients with DFI to highlight shared clinical patterns, diagnostic limitations, and poor outcomes. Two patients developed disseminated fusariosis with pulmonary nodules and characteristic necrotic cutaneous lesions, while the third developed Scedosporium prolificans fungemia with pulmonary involvement and progressive encephalopathy concerning for early central nervous system (CNS) dissemination. Diagnosis required a multimodal approach, including tissue biopsy, bronchoalveolar lavage (BAL), blood cultures, and advanced molecular testing; however, precise quantification of diagnostic delay was not systematically available across cases. In this series, diagnosis was nonetheless delayed relative to initial clinical presentation, largely due to nonspecific radiographic findings, initially negative or indeterminate cultures,…
How strong is the evidence?
Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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