Disseminated Scopulariopsis brevicaulis infection in an allogeneic stem cell recipient: case report and review of the literature

Salmon, Alexandra; Debourgogne, Anne; Vasbien, M.; Clément, Laurence; Collomb, J.; Plénat, François; Bordigoni, Pierre; Machouart, M.

doi:10.1111/j.1469-0691.2009.02878.x

Cited by 27 publications

(15 citation statements)

References 45 publications

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“…Antigen detection is potentially interesting. Aspergillus galactomannan was detected during a case of disseminated S. brevicaulis when there was no evidence of Aspergillus infection (22). Here, as in other cases of disseminated infection, all the GMs performed since the day of transplantation were negative.…”

Section: Case Reportmentioning

confidence: 69%

Fatal Invasive Infection with Fungemia Due to Microascus cirrosus after Heart and Lung Transplantation in a Patient with Cystic Fibrosis

et al. 2011

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Scopulariopsis species are rarely but increasingly recognized as opportunistic pathogens in immunocompromised patients. We report on a patient suffering from cystic fibrosis who developed disseminated fungal infection due to a rare Scopulariopsis species, Microascus cirrosus, after heart and lung transplantation. Despite antifungal combination therapy with voriconazole and caspofungin, the patient died 4 weeks after transplantation. Diagnostic difficulties and optimal management of disseminated Scopulariopsis/Microascus infections are discussed. CASE REPORTA 36-year-old man suffering from cystic fibrosis was admitted to our hospital in June 2009 for a heart and bilateral lung transplantation. He had a first lung transplantation in 1997 but had chronic rejection since 2001 in spite of several immunosuppressive regimens. His medical history also included renal failure (hemodialysis since 2007), diabetes mellitus, and airway colonization with a multiresistant Pseudomonas aeruginosa. Short antifungal therapy courses had been prescribed over the past years for various yeasts (Candida spp.) and molds (Aspergillus, Paecilomyces, and Fusarium species) colonizing his respiratory tract, but there was no evidence of previous isolation of a Scopulariopsis species. At the time of admission, sputum cultures grew only Candida albicans, and fluconazole was thus prescribed (200 mg intravenously [i.v.] after each dialysis).Following graft surgery, the immunosuppressive regimen included induction therapy with basiliximab (anti-CD25 antibody [20 mg i.v. on the day of transplantation and on day 4]) and solumedrol (10 mg/kg of body weight on the day of transplantation, followed by three 120-mg doses per day), followed by cyclosporine adjusted according to dialysis parameters to reach therapeutic blood levels (300 to 350 ng/ml) and solumedrol. Antimicrobial therapy consisted of a broad-spectrum antibiotherapy with tobramycin, vancomycin, piperacillin, and tazobactam. Although the patient seemed to do well in the early postoperative period, with apyrexia and extubation on day 3, his white blood cell count (WBC) increased slowly starting on the day after transplantation, reaching 20 ϫ 10 9 cells/liter by day 8 postsurgery. On day 11 after the operation (WBC ϭ 30 ϫ 10 9 cells/liter), a thoracic computed tomodensitometry (TDM) revealed bilateral pulmonary effusions (Fig. 1A), which were drained on day 19 without clinical improvement. Bilateral hemorrhagic pleural fluid specimens revealed several regular, hyaline, and branched septate hyphae on direct examination ( Fig. 2A), leading to the diagnosis of proven invasive fungal infection (IFI) according to the European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC/MSG) criteria (8). The patient was given an antifungal combination therapy of voriconazole i.v. (6 mg/kg every 12 h as a loading dose followed by two 4-mg/kg doses a day) and caspofungin (70 mg/day ...

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Section: Case Reportmentioning

confidence: 69%

Fatal Invasive Infection with Fungemia Due to Microascus cirrosus after Heart and Lung Transplantation in a Patient with Cystic Fibrosis

et al. 2011

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“…In these populations, soft tissue infection, invasive sinusitis, pneumonia, and disseminated disease are the most common clinical manifestations. [85][86][87][88][89][90][91] In case reports of patients with respiratory tract involvement, pulmonary nodules, cavities, dense consolidations, ground glass opacities, and pleural effusions are described. 86,[90][91][92] Other clinical manifestations include endocarditis, 93,94 mastoiditis, 85 cerebral abscesses, 95 and peritonitis.…”

Section: Epidemiology and Clinical Manifestationsmentioning

confidence: 99%

Non-Aspergillus Hyaline Molds: Emerging Causes of Sino-Pulmonary Fungal Infections and Other Invasive Mycoses

Jacobs

Wengenack

Walsh

2020

Semin Respir Crit Care Med

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Hyaline molds, widely distributed in nature, are an important and increasing cause of invasive fungal infections in humans, likely due to an expanding population of immunosuppressed hosts, increases in antifungal resistance, and improvements in laboratory diagnostics. Sinopulmonary disease and disseminated infection are common manifestations in neutropenic patients and transplant recipients, whereas, catheter-related and localized soft tissue infections predominate in immunocompetent hosts. These organisms are not reliably differentiated based on their morphology in tissue; rather, efforts should be made to establish a microbiologic diagnosis via culture or molecular-based methods to guide antifungal management and inform prognosis. Herein, we review the epidemiology, clinical manifestations, diagnosis, and management of these opportunistic pathogens known to cause hyalohyphomycoses: Scedosporium spp., Lomentospora prolificans, Fusarium spp., Scopulariopsis spp., Arthrographis kalrae, Trichoderma spp., Acremonium spp., Paecilomyces variotii, Purpureocillium lilacinum, and Penicillium species.

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“…Other sporadic forms are: infections of the lung (especially in old cavities, similar to aspergillosis), subcutaneous abscesses, peritoneal infections, sinusitis, otomycoses, keratitis mycotica, endophthalmitis. In recent times seborrheic dermatitis‐like lesions have been observed in AIDS patients [25].…”

Section: Hyalohyphomycosismentioning

confidence: 99%

Opportunistic filamentous mycoses: aspergillosis, mucormycosis, phaeohyphomycosis and hyalohyphomycosis

Perusquía-Ortiz

Vázquez-González

Bonifáz

2012

J Deutsche Derma Gesell

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Summary Opportunistic filamentous mycoses are widely distributed all over the world. They are rarely observed in Europe but are common in developing countries. The most common are the aspergilloses (due to Aspergillus spp.) mostly in neutropenia and immunosuppression; the mucormycoses characterized by rapid progression in patients with diabetic ketoacidosis; the phaeohyphomycoses due to pigmented fungi causing either a mild superficial or a very serious deep disease and the hyalohyphomycoses due to hyaline filamentous fungi (Fusarium spp., Pseudallescheria spp., Scopulariopsis spp.). Cutaneous manifestations are usually secondary to dissemination from pulmonary or visceral disease; primary cases are less frequent and due to direct inoculation into the skin. We review epidemiological, clinical, diagnostic, and therapeutic data on the four most important opportunistic filamentous mycoses: aspergillosis, mucormycosis, phaeohyphomycosis and hyalohyphomycosis.

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Disseminated Scopulariopsis brevicaulis infection in an allogeneic stem cell recipient: case report and review of the literature

Cited by 27 publications

References 45 publications

Fatal Invasive Infection with Fungemia Due to Microascus cirrosus after Heart and Lung Transplantation in a Patient with Cystic Fibrosis

Fatal Invasive Infection with Fungemia Due to Microascus cirrosus after Heart and Lung Transplantation in a Patient with Cystic Fibrosis

Non-Aspergillus Hyaline Molds: Emerging Causes of Sino-Pulmonary Fungal Infections and Other Invasive Mycoses

Opportunistic filamentous mycoses: aspergillosis, mucormycosis, phaeohyphomycosis and hyalohyphomycosis

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