Case Reports. Transient colonization with Scedosporium prolificans. Report of four cases in Madrid

Abstract

Four cases of transient colonization of the respiratory tract by Scedosporium prolificans are presented, two in patients with cystic fibrosis, one in a liver transplant patient and one in a patient with AIDS. Colonization versus infection by S. prolificans is discussed.

Scedosporium apiospermum: changing clinical spectrum of a therapy-refractory opportunist*

“…There seem to be large regional differences. Scedosporium apiospermum seems to be nearly absent from CF patients in Spain [241], where S. prolificans is prevalent. Potted plants may consitute a reservoir of the fungus (B. Cimon, unpublished data).…”

Infections due to Pseudallescheria/Scedosporium species in patients with advanced HIV disease — a diagnostic and therapeutic challenge

“…Colonization of the respiratory tract due to S. apiospermum and S. prolificans was extensively evaluated in cystic fibrosis patients and in liver transplant recipients. 22,45 Our review shows that colonization of the airway tract is not a rare event in AIDS patients. Interestingly, fungus ball formation in AIDS patients was exclusively caused by members of the P. boydii complex, although the lack of cases with fungus ball formations by S. prolificans may be due to the limited number of case reports.…”

“…The origin of the patients colonized or infected by S. prolificans correlates with known endemic areas in the northern part of the Iberian Peninsula, Australia and the USA. 22,40 Infections have rarely been reported from other countries. 41,42 Filamentous fungi enter the respiratory tract via inhalation; the skin, wounds, and eyes are infected by direct inoculation.…”

Epidemiology of Scedosporiosis

“…The relative proportions of different species seen correlates with the clinical epidemiology in Australia, where in one study, S. aurantiacum comprised approximately 45 % of all S. apiospermum complex isolates [5,18]. S. apiospermum has a uniform distribution worldwide, but the geographic occurrence of L. prolificans infections appears to be more varied with many case series reported from Australia and Spain [5,18,21,25,26]. However, infections are also increasingly recognized in the Netherlands, UK, California, Southern USA, Korea, Germany and France [4, 7, 14, 22, 27, 28, 29••].…”

“…In addition, molecular techniques were used to identify the organism to species level [45]. The pathogenic role of L. prolificans in immunocompetent CF patients is uncertain [25]; invasive disease following lung transplantation has been reported [46].…”