Disseminated fusariosis presenting as panniculitis-like lesions on the legs of a neutropenic girl with acute lymphoblastic leukemia.

Fusarium is a filamentous fungus found naturally in the soil and as a contaminant of plumbing systems. In immunocompetent patients, Fusarium causes localized infection, most commonly onychomycosis. Fusarium tends to be resistant to commonly used antifungal medications. In immunocompromised patients, this antifungal resistance is of particular concern because localized infection quickly becomes disseminated disease with high mortality rates. Disseminated fusariosis presents with skin lesions more often than any other systemic fungal infection. We present a case of fusariosis in an 11-year-old neutropenic patient with acute lymphoblastic leukemia whose only symptom of the fungal infection consisted of painful, indurated nodules and plaques on her legs. The diagnosis and treatment of this invasive fungal infection is also discussed.