DisseminatedScedosporium inflatum infection in a patient with acute myeloblastic leukemia

Marı́n, Juan Francisco Garcı́a; Sanz, MA; Sanz, Guillermo; Guarro, Josep; Martínez, María Luisa Martínez; Prieto, Mireya; Guého, E.; Menezo, J.L.

doi:10.1007/bf01972505

Cited by 57 publications

(36 citation statements)

References 10 publications

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“…Another intriguing aspect of S. prolificans infections not yet explained is why these infections were not noticed until the beginning of the 1990s [24,25]. It is probable that previous cases were confused with infections by S. apiospermum or even A. fumigatus.…”

Section: Resultsmentioning

confidence: 99%

Comparison of the virulence of Scedosporium prolificans strains from different origins in a murine model

Ortoneda¹,

Pastor²,

Mayayo

et al. 2002

Journal of Medical Microbiology

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Scedosporium prolificans is an emerging opportunist fungus that causes different types of infections in immunocompetent and immunosuppressed people. These infections show an irregular geographical distribution and, generally, disseminated systemic infections are noticed only in specific countries. This study used a murine model of disseminated infection by this fungus to assess if strains from different origins have different virulence. Two strains from each of four different sources (disseminated infection, localised infection, asymptomatic cystic fibrosis patients and the environment) were tested. Two strains of S. apiospermum of clinical origin were also included in the study; these were clearly less virulent than those of S. prolificans. The S. prolificans strains tested were classified in three groups according to their virulence. The groups with higher and lower virulence were represented by only one strain each, and the intermediate group contained six strains. No significant differences were found between the strains from different geographic areas or different forms of disease.

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Section: Resultsmentioning

confidence: 99%

Comparison of the virulence of Scedosporium prolificans strains from different origins in a murine model

Ortoneda¹,

Pastor²,

Mayayo

et al. 2002

Journal of Medical Microbiology

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“…asymptomatic colonization of the external ear or the respiratory tract; localized infections of the joints, nail, eye, and sphenoid sinus (21); and disseminated infections in immunocompromised patients (10) with hematological malignancies (20,31) or in organ transplant recipients (4). Similarly, S. apiospermum colonizes the tracheobronchial tree and causes mycetoma, invasive pulmonary infection (26), and disseminated infections of the central nervous system (11,13,14,17).…”

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confidence: 99%

In Vitro Activities of New and Conventional Antifungal Agents against ClinicalScedosporiumIsolates

Meletiadis¹,

Meis

Mouton

et al. 2002

Antimicrob Agents Chemother

221

164

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The susceptibilities of 13 clinical isolates of Scedosporium apiospermum and 55 clinical isolates of S. prolificans to new and conventional drugs belonging to three different classes of antifungal agents, the azoles (miconazole, itraconazole, voriconazole, UR-9825, posaconazole), the polyenes (amphotericin B, nystatin and liposomal nystatin), and allylamines (terbinafine), were studied by use of proposed standard M38-P of NCCLS. Low growth-inhibitory antifungal activities were found in vitro for most of the drugs tested against S. prolificans isolates, with the MICs at which 90% of isolates are inhibited (MIC 90 s) being >8 g/ml; the MIC 90 s of voriconazole and UR-9825, however, were 4 g/ml. S. apiospermum isolates were more susceptible in vitro, with the highest activity exhibited by voriconazole (MIC 90 s, 0.5 g/ml), followed by miconazole (MIC 90 s, 1 g/ml), UR-9825 and posaconazole (MIC 90 s, 2 g/ml), and itraconazole (MIC 90 s, 4 g/ml). The MICs of terbinafine, amphotericin B, and the two formulations of nystatin (for which no statistically significant differences in antifungal activities were found for the two species) for S. apiospermum isolates were high. Cross-resistance was observed among all the azoles except posaconazole and among all the polyenes except the lipid formulation. A distribution analysis was performed with the MICs of each drug and for each species. Bimodal and skewed MIC distributions were obtained, and cutoffs indicating the borders of different MIC subpopulations of the distributions were determined on the basis of the normal plot technique. These cutoffs were in many cases reproducible between 48 and 72 h.

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“…Scedosporium prolificans and Scedosporium apiospermum (Pseudallescheria boydii) are emerging filamentous fungi that cause fatal pulmonary or disseminated infections in immunocompromised patients and localized infections following penetrating trauma, near drowning, or intravenous drug abuse (2,3,13,14,17,18,20,21,23,26,29,30). Clinical isolates of S. prolificans possess in vitro resistance to flucytosine and amphotericin B, as well as itraconazole (ITC) and the newer triazoles voriconazole (VRC) and posaconazole (PSC) (2,3,7,17,21,26,37).…”

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“…Clinical isolates of S. prolificans possess in vitro resistance to flucytosine and amphotericin B, as well as itraconazole (ITC) and the newer triazoles voriconazole (VRC) and posaconazole (PSC) (2,3,7,17,21,26,37). Similarly, S. apiospermum isolates are frequently resistant to amphotericin B and flucytosine and have variable susceptibilities to ITC, VRC, and PSC (7,10,13,18,20,29,35).…”

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Antifungal Triazoles and Polymorphonuclear Leukocytes Synergize To Cause Increased Hyphal Damage toScedosporium prolificansandScedosporium apiospermum

Gil-Lamaignere

Roilides

Mosquera

et al. 2002

Antimicrob Agents Chemother

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Scedosporium prolificans and Scedosporium apiospermum (Pseudallescheria boydii) cause pulmonary and disseminated infections refractory to most currently used antifungal agents in immunocompromised patients. We therefore investigated the potential antifungal activities of the triazoles itraconazole (ITC), voriconazole (VRC), and posaconazole (PSC) in combination with human polymorphonuclear leukocytes (PMNs) against the hyphae of these fungal pathogens. A colorimetric assay with (2,3-bis[2-methoxy-4-nitro-5-sulfophenyl]2H-tetrazolium-5-carboxanilide) sodium salt was used for the measurement of hyphal damage as an indicator of antifungal activity. We found that the newer triazoles VRC and PSC displayed synergistic effects with PMNs against S. prolificans hyphae after 24 h (P < 0.05), whereas the effect of ITC in combination with PMNs was additive (P < 0.01). All three triazoles displayed additive antifungal activities in combination with PMNs against S. apiospermum hyphae (P < 0.05). The synergistic or additive effects that these triazoles exhibited, combined with the antifungal activities of human PMNs, may have important therapeutic implications for the management of infections due to S. prolificans and S. apiospermum.Scedosporium prolificans and Scedosporium apiospermum (Pseudallescheria boydii) are emerging filamentous fungi that cause fatal pulmonary or disseminated infections in immunocompromised patients and localized infections following penetrating trauma, near drowning, or intravenous drug abuse (2,

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DisseminatedScedosporium inflatum infection in a patient with acute myeloblastic leukemia

Cited by 57 publications

References 10 publications

Comparison of the virulence of Scedosporium prolificans strains from different origins in a murine model

Comparison of the virulence of Scedosporium prolificans strains from different origins in a murine model

In Vitro Activities of New and Conventional Antifungal Agents against ClinicalScedosporiumIsolates

Antifungal Triazoles and Polymorphonuclear Leukocytes Synergize To Cause Increased Hyphal Damage toScedosporium prolificansandScedosporium apiospermum

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