Fatal pulmonary scedosporiosis

Abstract

We report on a case of scedosporiosis in a 72-year-old German woman. Her disease started with a purulent ulceration of unknown course at her left foot. Soon after onset of oral antibacterial therapy she needed in-hospital treatment because of an acute pneumonia. The infection progressed despite the application of different antibiotics. Microscopic examination of tracheal fluid revealed fungal hyphae and therefore treatment with itraconazole was initiated. However, the patient developed renal failure, required mechanical ventilation and finally died in treatment-resistant septic shock. Post-mortem Scedosporium apiospermum was cultured from lung tissue taken during autopsy. This is the fourth case of human infection caused by Scedosporium species diagnosed in our laboratory during the last 4 years.

Invasive infections caused by Blastoschizomyces capitatus and Scedosporium spp.

“…There have been reports of keratitis after trauma or surgery and even without previous ocular injury [ [100][101][102][103], in conjunction with chorioretinitis [104], vertebral osteomyelitis [105], post-traumatic cranial infection [106], lymphocutaneous syndrome [107], lymphadenitis [108] and septic arthritis [109]. A case of disseminated fatal disease after a post-traumatic osteomyelitis has also been described [110]. S. apiospermum may also colonise the respiratory tract of patients with cystic fibrosis [111,112].…”

Infections due to Pseudallescheria/Scedosporium species in patients with advanced HIV disease — a diagnostic and therapeutic challenge

“…Since the rate of dissemination in previously healthy patients, for example after near-drowning, is similar to the data presented here, immunosuppression appears not to be a precondition for CNS manifestations. [51][52][53] In our patient, TE was suspected based on typical contrast-enhancing masses in the MRI, neurological symptoms, seropositivity for Toxoplasmaspecific IgG antibodies, and initial remission of clinical symptoms after administration of antiparasitic therapy. Since similar lesions of different size were the most common finding reported from CNS infections due to members of the P. boydii complex, 54 a computed tomography (CT)-guided needle biopsy at the first time of deterioration would have been required to confirm the diagnosis in our patient.…”