Scedosporium prolificans: an emerging pathogen in France?

Abstract

For the last ten years, non-Aspergillus mold species have been increasingly involved in human invasive infections, probably as a consequence of more intense immunosuppression and prolonged patient survival, and of selective pressure since antifungal agents are currently used for prophylaxis or therapy. Scedosporium prolificans, one of these emerging fungi, has been isolated in a broad spectrum of clinical presentations in humans, including respiratory-tract colonization, superficial or locally invasive infections, and disseminated infections in immunocompromised patients. Here, we report the recent emergence of invasive infections due to S. prolificans in France, and describe four new cases diagnosed during the last six years. Only one disseminated scedosporiosis has been reported before this in France, in 1994. Three out of our four cases were breakthrough infections in immunocompromised patients receiving posaconazole or voriconazole therapy. The aims of the present review were thus to gain a better understanding of scedosporiosis epidemiology and clinical features, and to review recent advances in multimodal management of these infections, including surgery, recovery and/or enhancement of immunity, and antifungal combinations, especially voriconazole plus terbinafine.

Infective endocarditis caused by Scedosporium prolificans infection in a patient with acute myeloid leukemia undergoing induction chemotherapy

“…This distribution is thought to be associated with a semi-arid climate; however, there are reports of S. prolificans infections in other countries, although these are rare [12]. The first Japanese case was reported in 2011.…”

Susceptibility and Diversity in the Therapy-Refractory Genus Scedosporium

“…Variability is noted in both genes studied (BT2 as well as in ITS) and is also recognized in AFLP profiles, although degrees of variability differ between groups. Unambiguous separation was achieved between S. desertorum, S. minutisporum, and S. aurantiacum, while S. prolificans is also known to constitute a separate entity, recently even at the generic level L. prolificans (11,25). The remaining species formed two complexes, one consisting of S. deficiens/S.…”

Melanized Fungi in Human Disease

“…Multiple genotypes were previously suggested by inter-simple-sequence-repeat (ISSR) fingerprinting (708). Increased numbers of infections with S. prolificans have also been reported from France (304) and Australia (190). Inflated annellides, a key microscopic feature in the identification of this organism, may be subtle in some isolates and easily overlooked.…”

“…The most common isolate was S. prolificans, accounting for over a third of cases. Since that review, S. prolificans remains the most frequent cause of disseminated disease, almost exclusively in immunocompromised patients (33,62,96,151,304,358,364,368,434,697,709,747,750,796). E. dermatitidis, in contrast, is commonly seen in immunocompetent patients, particularly from Asia (13,349,565).…”