{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T13:09:54Z","timestamp":1789736994015,"version":"4.0.1"},"reference-count":13,"publisher":"BMJ","issue":"9","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,8,26]]},"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:p>\n                    Hairy cell leukaemia (HCL) is a B-cell malignancy whose induction chemotherapy consists of 5\u2009days of cladribine, a purine nucleoside analogue. While there are consensus guidelines from the National Comprehensive Cancer Network (NCCN) on antifungal prophylaxis in the setting of acute myeloid leukaemia or acute lymphocytic leukaemia, there are no consensus guidelines for antifungal prophylaxis during induction treatment of HCL. We describe a case of angioinvasive\n                    <jats:italic>Fusarium<\/jats:italic>\n                    infection in a healthy, young patient who completed cladribine chemotherapy for HCL. While rare, fusariosis poses a significant morbidity and mortality risk in neutropenic patients undergoing treatment. Prevention of fusariosis requires appropriate prophylactic agents and treatment requires resolution of neutropenia and the elimination of the fungus. This case highlights early recognition and prompt start of antifungals as the cornerstone of management. Antifungal prophylaxis is not routinely recommended during HCL induction, and whether patients might benefit from prophylaxis warrants further study.\n                  <\/jats:p>","DOI":"10.1136\/bcr-2025-271236","type":"journal-article","created":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T13:00:11Z","timestamp":1789736411000},"page":"e271236","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Disseminated\n                    <i>Fusarium<\/i>\n                    infection following cladribine chemotherapy for hairy-cell leukaemia"],"prefix":"10.1136","volume":"19","author":[{"given":"Matthew","family":"Dandan","sequence":"first","affiliation":[{"name":"Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saba","family":"Anwer","sequence":"additional","affiliation":[{"name":"Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Kidwell","sequence":"additional","affiliation":[{"name":"Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sol Del Mar","family":"Aldrete","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease, Medical College of Wisconsin, Milwaukee, Wisconsin, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,9,18]]},"reference":[{"key":"2026091806000535000_19.9.e271236.1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2016-01-689422"},{"key":"2026091806000535000_19.9.e271236.2","doi-asserted-by":"crossref","DOI":"10.1038\/s41408-022-00702-9","article-title":"Long-term follow-up of cladribine treatment in hairy cell leukemia: 30-year experience in a multicentric Italian study","volume":"12","author":"Pagano","year":"2022","journal-title":"Blood Cancer J"},{"key":"2026091806000535000_19.9.e271236.3","doi-asserted-by":"crossref","DOI":"10.3390\/jof7100815","article-title":"Invasive Fusariosis in Patients with Hematologic Diseases","volume":"7","author":"Nucci","year":"2021","journal-title":"J Fungi (Basel)"},{"key":"2026091806000535000_19.9.e271236.4","doi-asserted-by":"crossref","unstructured":"Nucci M , Anaissie E . Invasive fusariosis. Clin Microbiol Rev 2023;36. doi:10.1128\/cmr.00159-22","DOI":"10.1128\/cmr.00159-22"},{"key":"2026091806000535000_19.9.e271236.5","doi-asserted-by":"crossref","first-page":"869","DOI":"10.1016\/j.jaad.2018.04.059","article-title":"Angioinvasive fungal infections impacting the skin: Background, epidemiology, and clinical presentation","volume":"80","author":"Shields","year":"2019","journal-title":"J Am Acad Dermatol"},{"key":"2026091806000535000_19.9.e271236.6","article-title":"Fusariosis: An Invasive Fungal Disease in a Neutropenic Patient With Acute Myeloid Leukemia","volume":"14","author":"Asiimwe","year":"2022","journal-title":"Cureus"},{"key":"2026091806000535000_19.9.e271236.7","doi-asserted-by":"crossref","DOI":"10.3390\/jof6040239","article-title":"Fosmanogepix: A Review of the First-in-Class Broad Spectrum Agent for the Treatment of Invasive Fungal Infections","volume":"6","author":"Shaw","year":"2020","journal-title":"J Fungi (Basel)"},{"key":"2026091806000535000_19.9.e271236.8","doi-asserted-by":"crossref","first-page":"e302","DOI":"10.1093\/cid\/ciaf185","article-title":"Fosmanogepix for the Treatment of Invasive Mold Diseases Caused by Aspergillus Species and Rare Molds: A Phase 2, Open-Label Study (AEGIS)","volume":"81","author":"Hodges","year":"2025","journal-title":"Clin Infect Dis"},{"key":"2026091806000535000_19.9.e271236.9","doi-asserted-by":"crossref","first-page":"848","DOI":"10.1093\/cid\/ciad309","article-title":"Fosmanogepix Therapy of Disseminated Fusarium Infection","volume":"77","author":"Winston","year":"2023","journal-title":"Clin Infect Dis"},{"key":"2026091806000535000_19.9.e271236.10","doi-asserted-by":"crossref","unstructured":"Goggin KP , et al . Successful use of fosmanogepix for treatment of rare multidrug-resistant cutaneous Fusarium suttonianum infection. Open Forum Infect Dis 2023;10. doi:10.1093\/ofid\/ofad285","DOI":"10.1093\/ofid\/ofad285"},{"key":"2026091806000535000_19.9.e271236.11","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1093\/mmy\/myz060","article-title":"A retrospective cohort of invasive fusariosis in the era of antimould prophylaxis","volume":"58","author":"Fern\u00e1ndez-Cruz","year":"2020","journal-title":"Med Mycol"},{"key":"2026091806000535000_19.9.e271236.12","doi-asserted-by":"crossref","first-page":"1489","DOI":"10.1099\/jmm.0.001059","article-title":"Epidemiological aspects and characterization of the resistance profile of Fusarium spp. in patients with invasive fusariosis","volume":"68","author":"Rosa","year":"2019","journal-title":"J Med Microbiol"},{"key":"2026091806000535000_19.9.e271236.13","doi-asserted-by":"crossref","first-page":"1005","DOI":"10.1002\/jha2.982","article-title":"Incidence, description, and timing of serious and opportunistic infections in patients with hairy cell leukemia","volume":"5","author":"Kapoor","year":"2024","journal-title":"EJHaem"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-271236","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T13:00:14Z","timestamp":1789736414000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-271236"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":13,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2026,9,18]]},"published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1136\/bcr-2025-271236"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-271236","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9]]}}}