Disseminated Infection and Colonization by Scedosporium prolificans: A Review of 18 Cases, 1990-1999

Abstract

Scedosporium prolificans infection was analyzed in 18 patients from whom the fungus was isolated during the period 1990-1999. Of these 18 patients, 12 had some predisposing factor and either unconfirmed infection or colonization, and 6 patients had confirmed disseminated infection: 4 patients with leukemia died, 1 patient with breast cancer who underwent autologous bone marrow transplantation survived, and 1 patient with advanced acquired immunodeficiency syndrome died, although the fungal infection did not seem to affect his clinical symptoms.

Molecular Typing of AustralianScedosporiumIsolates Showing Genetic Variability and NumerousS. aurantiacum

“…Of note, no specifi c genotypes were associated with underlying medical conditions or risk factors. Compared with S. apiospermum and S. aurantiacum S. prolifi cans was more frequently associated with coincident hospital renovation, and invasive disease, had a greater predilection to cause disseminated infection and was the predominant species isolated from blood and other sterile sites (12)(13)(14)(15)(16)36; current study). Our preliminary observations indicate that the epidemiology and clinical relevance of recovering S. aurantiacum may be similar to that of S. apiospermum.…”

“…On the basis of genetic data, a new species, S. aurantiacum, was proposed for a subset of isolates previously identifi ed as S. apiospermum (11). S. prolifi cans infections are geographically more restricted than those caused by S. apiospermum, being most prevalent in Australia, Spain, and the United States (12)(13)(14)(15). S. prolifi cans typically causes localized infections in immunocompetent hosts but rapidly fatal disseminated infections in the immunocompromised among whom it has been associated with nosocomial outbreaks (3,(12)(13)(14)(15)(16)(17).…”

Scedosporium Prolificans Sclerokeratitis Following Pterygium Excision with Mitomycin C: A Case Requiring Enucleation

“…Cases have been reported in Australia, California, and the Southern United States [2]. Susceptibility profiling reveals high mean inhibitory concentrations (MIC) for Scedosporium species and voriconazole has the most favorable profile.…”

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

“…3,14 , pero también ha sido aislado de tierra de maceteros y en el aire de una habitación de un paciente leucémico 15 y considerado como un patógeno emergente en ciertas áreas del mundo como España y Australia 3,5,14,15 . El reservorio probable en nuestro paciente, según planteamiento del equipo tratante, habría sido el aire ambiental, y vía de infección, la caída de conidios sobre la herida abierta durante el acto quirúrgico -no se dispone de flujo laminar en los pabellones quirúrgicos del establecimiento-, el que fuera laborioso y más prolongado de lo habitual por complicaciones durante la sutura de los vasos sanguíneos.…”

“…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 .…”