Nails and skin co-infection by Fusarium verticillioides and Proteus vulgaris secondary to arterial occlusion of lower extremity.

Abstract

Background: Post-traumatic Fusarium infection is rare. Arterial occlusive disease, a common vascular disorder in the elderly, often leads to ischemic necrosis of the lower extremities, which in turn increases the likelihood of secondary infections. Those secondary infections can be caused by bacteria, virus, or fungi.

Case report: We present the case of a 64-year-old male patient with a co-infection by Fusarium verticillioides and Proteus vulgaris on nails and foot skin, secondary to senile arterial occlusion on the lower extremities. The skin and nails recovered well after following stent implantation and a combination treatment of itraconazole and a macrolide antibiotic. A retrospective analysis of the literature identified 17 patients with Fusarium infection, all of whom were immunocompetent.

Conclusions: Trauma may be a predisposing cause of Fusarium infection. Combination of oral itraconazole and terbinafine, or amphotericin B and surgical means, are all effective treatments.