Disseminated Angioinvasive Fusarium Infection following Chimeric Antigen Receptor T-Cell Therapy in Refractory Diffuse Large B-Cell Lymphoma: A Case Report.

INTRODUCTION

Patients receiving immune-directed chimeric antigen receptor T-cell (CAR-T) therapy experience profound, prolonged immunosuppression, predisposing them to opportunistic infections. Disseminated angioinvasive Fusarium infections are uncommon but carry high morbidity and mortality in this population.

CASE PRESENTATION: We describe a rare case of disseminated angioinvasive Fusarium infection in a patient with refractory diffuse large B-cell lymphoma following CD19-directed CAR-T-cell therapy. The patient developed progressive cutaneous lesions due to Fusarium keratoplasticum complex, confirmed by tissue culture and histopathology. She ultimately expired due to septic shock complicated by multifactorial cardiotoxicity.

CONCLUSION

This case highlights the heightened susceptibility to refractory opportunistic mold infections and potential cardiac complications in patients after CAR-T therapy. New skin lesions in the post-CAR-T period should prompt early biopsy and skin culture with prompt mold coverage.