Epidemiology, clinical manifestations, and outcomes of Scedosporium infections among solid organ transplant recipients

Abstract

LTR were most susceptible to Scedosporium colonization and scedosporiosis, particularly within the lungs. Death was common with scedosporiosis in the first year after all types of organ transplants, consistent with profound immunosuppression and antifungal resistance, but not encountered thereafter.

Clinical outcome of cystic fibrosis patients colonized by Scedosporium species following lung transplantation: A single‐center 15‐year experience

“…Treatment of Scedosporium species colonization consisted of long‐term itraconazole and fluconazole; none of the patients became undetectable for the fungus, but none developed disseminated scedosporial infection either. A more recent article from Johnson et al . described colonization by Scedosporium species in 16 lung transplant recipients, including 3 who had CF as their underlying disease; 13 patients received a prophylaxis by azole, while the 3 remaining patients had colonization diagnosed >1 year after transplantation and did not have any specific treatment.…”

“…The pathogenicity of Scedosporium species is real and closely related to the immunological status of patients. Several case reports had been published reporting fatal disseminated Scedosporium species infection in lung transplant recipients with CF (Table ). However, such events remain scarce and probably represent publication bias, as successful long‐term LT in CF patients colonized by Scedosporium species is rarely reported.…”

“…In CF patients prior to LT, the colonization is mostly asymptomatic, although allergic bronchopulmonary disease and rare Scedosporium species infections have been described . After LT, colonized patients may develop invasive airway disease and disseminated infections …”

Combination Antifungal Therapy: When, Where, and Why

“…Scedosporium species are soil molds that can cause infection in the setting of trauma or immunosuppression and are often intrinsically resistant to polyenes, echinocandins, and most triazoles [50]. Given the rarity of these infections, high incidence of resistance and poor outcomes, in vitro studies were performed comparing different combinations of current antifungal agents including polyenes, echinocandins, triazoles, and terbinafine to look for synergy against the two most common species, Scedosporium apiospermum and Scedosporium prolificans [51].…”

Scedosporiosis in a Combined Kidney and Liver Transplant Recipient: A Case Report of Possible Transmission from a Near-Drowning Donor

“…Cases of infections with Scedosporium spp. are reported worldwide and can range in severity from colonization or local infection to disseminated disease [1–5]. S. apiospermum most commonly infects the lungs as inhalation is often the suspected mode of organism acquisition [6].…”