Case Report of Vertebral Osteomyelitis and Mycotic Abdominal Aortic Aneurysm Caused by Scedosporium apiospermum in a Lung Transplant Patient With Cystic Fibrosis

Perspectives on Scedosporium species and Lomentospora prolificans in lung transplantation: Results of an international practice survey from ESCMID fungal infection study group and study group for infections in compromised hosts, and European Confederation of Medical Mycology

“…However, in the literature bronchial colonization is not often detected prior to transplantation as 57% (8 of 14) of patients with mold infections in their explanted lungs were not diagnosed or suspected before transplantation . Very few cases of post‐transplant invasive scedosporiosis in lung transplant recipients with CF or with other chronic respiratory diseases have been reported in the literature. Prior bronchial colonization was not always described in these case reports, but when present, the colonizing species could be considered responsible for the invasive disease .…”

Clinical outcome of cystic fibrosis patients colonized by Scedosporium species following lung transplantation: A single‐center 15‐year experience

“…The pathogenicity of Scedosporium species is real and closely related to the immunological status of patients. Several case reports had been published reporting fatal disseminated Scedosporium species infection in lung transplant recipients with CF (Table ). However, such events remain scarce and probably represent publication bias, as successful long‐term LT in CF patients colonized by Scedosporium species is rarely reported.…”

“…In CF patients prior to LT, the colonization is mostly asymptomatic, although allergic bronchopulmonary disease and rare Scedosporium species infections have been described . After LT, colonized patients may develop invasive airway disease and disseminated infections …”

“…Recent taxonomic studies indicate that S. apiospermum is a species complex, comprising at least five closely related, but distinct, species, ie, S. apiospermum complex sensu stricto (anamorph state of Pseudallescheria apiosperma), Scedosporium boydii (anamorph state of Pseudallescheria boydii), Scedosporium aurantiacum, Scedosporium dehoogii, and Pseudallescheria minutispora. 3,4 Scedosporium species account for approximately 25% of non-Aspergillus filamentous fungal infections in organ transplant recipients, 5,6 and several cases of lethal invasive Scedosporium species infections have been reported in patients who had undergone LT. [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] Scedosporium species are ubiquitously present in soil, sewage, and polluted waters. 1 The fungus can enter via the respiratory tract and colonize the sinuses and airways of patients with underlying pulmonary diseases such as CF.…”

“…[24][25][26][27][28][29][30] After LT, colonized patients may develop invasive airway disease and disseminated infections. [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] Scedosporium species are associated with infections with poor prognosis in lung transplant recipients. This high mortality rate could be explained by the difficulty of establishing an early diagnosis, the resistance to antifungal therapy, and finally the loss of grafts secondary to the reduction of immunosuppression that is part of the management of these infections.…”