Disseminated fusariosis with immune reconstitution syndrome and cracking mycotic aortic aneurysm in a 55-year-old patient with acute myeloid leukaemia

A 55-year-old woman with acute myeloid leukaemia (AML) developed fever and painful subcutaneous nodules during neutropenia following induction chemotherapy. Disseminated fusariosis was diagnosed as Fusarium spp. grew from skin biopsy and blood cultures. Liposomal amphotericin B and voriconazole were started, then subcutaneous nodules gradually disappeared. Immune reconstitution inflammatory syndrome (IRIS) was suspected 2 months later, as during immune recovery subcutaneous nodules appeared again (figure 1A), without Fusarium spp. in culture from skin biopsy …