Clinical Resolution of Scedosporium prolificans Fungemia Associated with Reversal of Neutropenia Following Administration of Granulocyte Colony-Stimulating Factor

Bouza, Emilio; Muñoz, Pilar; Vega, L.; Rodríguez‐Créixems, Marta; Berenguer, Juan; Escudero, Antonio

doi:10.1093/clinids/23.1.192

Cited by 62 publications

(58 citation statements)

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“…It may be possible that the addition of G-CSF to the antifungal therapy based on liposomal amphotericin B may be a useful adjunctive therapy. Consistent with these experimental observations, a neutropenic patient survived Scedosporium prolificans fungemia with amphotericin B plus itraconazole plus G-CSF, when the neutrophil count started to recover (52).…”

Section: Immunotherapysupporting

confidence: 74%

“…The most common infected sites were lungs, kidneys, brain, and spleen (35). It has been suggested that cytokines (G-CSF) in combination with antifungals may have increased efficacy against Scedosporium infections (52). In vitro studies have suggested that an amphotericin B lipid complex in combination with PMNs has significantly greater antifungal activity against Scedosporium spp.…”

Section: Immunotherapymentioning

confidence: 99%

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Infections Caused byScedosporiumspp

et al. 2008

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SUMMARY Scedosporium spp. are increasingly recognized as causes of resistant life-threatening infections in immunocompromised patients. Scedosporium spp. also cause a wide spectrum of conditions, including mycetoma, saprobic involvement and colonization of the airways, sinopulmonary infections, extrapulmonary localized infections, and disseminated infections. Invasive scedosporium infections are also associated with central nervous infection following near-drowning accidents. The most common sites of infection are the lungs, sinuses, bones, joints, eyes, and brain. Scedosporium apiospermum and Scedosporium prolificans are the two principal medically important species of this genus. Pseudallescheria boydii, the teleomorph of S. apiospermum, is recognized by the presence of cleistothecia. Recent advances in molecular taxonomy have advanced the understanding of the genus Scedosporium and have demonstrated a wider range of species than heretofore recognized. Studies of the pathogenesis of and immune response to Scedosporium spp. underscore the importance of innate host defenses in protection against these organisms. Microbiological diagnosis of Scedosporium spp. currently depends upon culture and morphological characterization. Molecular tools for clinical microbiological detection of Scedosporium spp. are currently investigational. Infections caused by S. apiospermum and P. boydii in patients and animals may respond to antifungal triazoles. By comparison, infections caused by S. prolificans seldom respond to medical therapy alone. Surgery and reversal of immunosuppression may be the only effective therapeutic options for infections caused by S. prolificans.

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Section: Immunotherapysupporting

confidence: 74%

Section: Immunotherapymentioning

confidence: 99%

Infections Caused byScedosporiumspp

et al. 2008

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“…Es un hongo filamentoso con resistencia in vitro a todos los antifúngicos en uso actualmente, por lo cual el manejo terapéutico puede llegar a ser difícil y no está claro aún cuál es la terapia antifúngica ideal. A pesar de que este hongo muestra resistencia in vitro a los antifúngicos, algunos casos tratados han evolucionado favorablemente 7,20,22 . No obstante de que existe discordancia entre los resultados de estudios in vitro y respuesta clínica, hecho descrito por lo demás para otras infecciones fúngicas, creemos que los ensayos de susceptibilidad tienen un rol orientador siendo de utilidad de ejecución.…”

Section: Discussionunclassified

“…Con respecto al tratamiento, en la mayoría de las infecciones diseminadas es necesario la eliminación de la inmunodepresión para obtener algún tipo de respuesta 7 . En infecciones localizadas, como en este caso, es importante la cirugía unida al tratamiento antifúngico.…”

Section: Discussionunclassified

“…Scedosporium prolificans ha emergido como una causa importante de infecciones localizadas y diseminadas severas, principalmente en individuos inmunocomprometidos [2][3][4][5][6] , neutropénicos 7 , pacientes con enfermedades onco hematológicas [8][9][10][11][12] y sometidos a trasplantes 13,14 . Se ha comunicado además, un brote nosocomial constituído por 4 casos de infecciones diseminadas fatales en pacientes leucémicos 8 .…”

Section: Introductionunclassified

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Absceso de herida operatoria por Scedosporium prolificans: Primer aislamiento en Chile. Revisión de la literatura

Rodríguez-Tudela

2004

Rev. chil. infectol.

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Absceso de herida operatoria porThe aim of this article is to report the first case of infection by Scedosporium prolificans in our country. The patient corresponds to a 27 year-old man with chronic renal failure, hypertension, submitted to a renal transplant, in treatment with cyclosporine, azathioprine and prednisone. Twenty five days after the transplant, he noticed a fluctuating increase of volume under the surgical wound. In three consecutive purulent exudates and in tissue obtained at surgery, Scedosporium prolificans was isolated as an only agent. The histopathological study revealed structures compatible with septate hyphae. The patient was treated by surgical debridement, Amphotericin B and Itraconazol obtaining a complete cicatrization of the wound. S prolificans is a hyaline filamentous fungi, resistant to Amphotericin B and azoles, considered currently an emerging pathogen. It is responsible of localized infections associated to surgery and/or trauma, as well as fatal disseminated infections in immunocompromised hosts, specially oncological, in presence of neutropenia, and transplants. It is important to consider this microorganism in the differential diagnosis of emerging fungal infections.

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Management of Infection With Naturally Amphotericin B-Resistant Fungi

Tan¹,

Barnes²

2004

Management of Multiple Drug-Resistant Infections

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Clinical Resolution of Scedosporium prolificans Fungemia Associated with Reversal of Neutropenia Following Administration of Granulocyte Colony-Stimulating Factor

Cited by 62 publications

References 0 publications

Infections Caused byScedosporiumspp

Infections Caused byScedosporiumspp

Absceso de herida operatoria por Scedosporium prolificans: Primer aislamiento en Chile. Revisión de la literatura

Management of Infection With Naturally Amphotericin B-Resistant Fungi

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