Clinical Features and Outcomes of Invasive Fusarium Infections from a Singaporean Centre: Is It Time to Redefine How We Assess Treatment Outcomes?

Invasive <i>Fusarium</i> infections pose a significant threat to immunocompromised patients and are characterised by high mortality rates. In this study, we examined 22 unique episodes of proven and probable <i>Fusarium</i> infections over a 14-year period at a tertiary hospital in Singapore. Cases were analysed from clinical, microbiological, and radiological perspectives. The most common risk factor for invasive <i>Fusarium</i> infections was hematologic malignancy. Fifty percent of patients achieved resolution of infection and were alive at the end of treatment. Conversely, the overall mortality was 50%, with 90% of deaths occurring within three months of the diagnosis of invasive fusariosis; associated risk factors include neutropenia, disseminated infection, and corticosteroid use. Although these deaths would be classified as treatment failures by established criteria; many (8/10; 80%) were due to causes not directly related to invasive fusariosis; such as progression of the underlying malignancy or another infection. We believe that it may be time to redefine how we assess treatment outcomes for invasive mould infections. Nevertheless; invasive fusariosis remains a formidable foe in the immunocompromised host. Early; aggressive treatment with appropriate adjunctive therapies; such as surgery; is crucial for controlling the infection and achieving the best outcomes.