Scedosporium spp lung infection in immunocompetent patients

Liu, Wei; Feng, Ruizhi; Jiang, Hongli

doi:10.1097/md.0000000000017535

Cited by 23 publications

(26 citation statements)

References 56 publications

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“…Our recent review revealed a delay of 5.5 months in the diagnosis of Scedosporium infection in immunocompetent patients; 16 this was much longer than the duration reported for patients with a history of near-drowning. 17 Diagnostic delays may lead to inappropriate treatment with grave consequences, even in immunocompetent patients.…”

Section: Discussionmentioning

confidence: 68%

“…Whereas outcomes were generally dismal after voriconazole monotherapy in immunocompromised patients with S. apiospermum lung infections, the overall response was 83.3% in immunocompetent patients with S. apiospermum lung infections. 16 However, voriconazole is inhibitory, rather than fungicidal. 26,27 Voriconazole treatment was ineffective for our patient; thus, surgical resection was necessary.…”

Section: Discussionmentioning

confidence: 99%

“…infection who underwent surgery to ensure treatment efficacy or prevent recurrence. 16 Among these five patients, postoperative voriconazole was administered in two; treatment durations were 3 months and 4 months, respectively. 28,29 In our patient, a 6-month course of postoperative systemic voriconazole treatment was prescribed; no drug-related side effects were observed.…”

Section: Discussionmentioning

confidence: 99%

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Management of pulmonary Scedosporium apiospermum infection by thoracoscopic surgery in an immunocompetent woman

2020

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The Scedosporium apiospermum complex is a group of emerging opportunistic fungal pathogens that affect both immunocompromised and immunocompetent individuals, most commonly via lung infection. Although they are resistant to many antifungal agents, this group of pathogens has a favorable susceptibility profile to azoles, especially voriconazole. Here, we describe the management of S. apiospermum infection in an otherwise healthy 44-year-old woman. She had exhibited intermittent hemoptysis for 2 years before admission to our hospital. Computed tomography revealed a thin-walled and well-circumscribed cavitary lesion in the left upper lobe; the lesion was filled with consolidative opacities. Fungal culture of bronchoalveolar lavage fluid specimens revealed grayish-white mold; lactophenol cotton blue staining revealed acute angle branched septate hyaline cylindrical hyphae, characteristic of S. apiospermum. Despite voriconazole 200 mg twice daily for 8 weeks, the patient showed no improvement; thus, her left upper lobe was removed via thoracoscopic surgery. Her symptoms immediately improved and chest radiography after surgical resection showed no evidence of radiological progression or reoccurrence. This report demonstrates that S. apiospermum lung infection may not respond well to voriconazole alone in immunocompetent hosts; thus, surgery could be curative for these patients.

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Section: Discussionmentioning

confidence: 68%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Management of pulmonary Scedosporium apiospermum infection by thoracoscopic surgery in an immunocompetent woman

2020

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“…1 The genus Scedosporium comprises at least 10 species, of which S. apiospermum, S. boydii, S. aurantiacum and Lomentospora prolificans (formerly known as Scedosporium prolificans) are the most common species causing infections in humans. 2 Scedosporium/Lomentospora species can cause allergic bronchopulmonary mycosis, pneumonia, sinusitis, meningitis, brain abscess, arthritis, osteomyelitis, endocarditis, cutaneous and subcutaneous infections, keratitis, endophthalmitis and disseminated infection. [3][4][5] They can also colonise the respiratory tract in patients with cavitary lung disease, secondary to tuberculosis, cystic fibrosis and bronchiectasis.…”

Section: Introductionmentioning

confidence: 99%

“…boydii , S . aurantiacum and Lomentospora prolificans (formerly known as Scedosporium prolificans ) are the most common species causing infections in humans 2 . Scedosporium / Lomentospora species can cause allergic bronchopulmonary mycosis, pneumonia, sinusitis, meningitis, brain abscess, arthritis, osteomyelitis, endocarditis, cutaneous and subcutaneous infections, keratitis, endophthalmitis and disseminated infection 3–5 .…”

Section: Introductionmentioning

confidence: 99%

Clinical manifestations and susceptibility of Scedosporium/Lomentospora infections at a tertiary medical centre in Taiwan from 2014 to 2021: A retrospective cohort study

Lao

Fan

et al. 2023

Mycoses

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BackgroundScedosporiosis/lomentosporiosis is a globally emerging and crucial fungal infection. However, clinical data on Scedosporium/Lomentospora infections in Taiwan are scarce.ObjectivesThis study aimed to explore the clinical characteristics of Scedosporium/Lomentospora‐infected patients and evaluate the susceptibility of these isolates to antifungal agents.MethodsThe clinical features of Scedosporium/Lomentospora‐infected patients at a tertiary teaching hospital in Northern Taiwan between 2014 and 2021 were retrospectively reviewed; isolates from these patients were identified to species level for antifungal susceptibility testing.ResultsAmong 44 patients, 27 (61.4%) had scedosporiosis/lomentosporiosis, whereas 17 (38.6%) were colonised with Scedosporium/Lomentospora species. Scedosporium apiospermum was the main coloniser; scedosporiosis was primarily caused by S. boydii. Trauma history, steroid and immunosuppressant use were the most common risk factors for developing these infections. Among 27 patients with scedosporiosis/lomentosporiosis, one was lost to follow‐up and seven (7/26, 26.9%) died. Most patients with S. apiospermum infection have a history of trauma, leading to cutaneous, bone and ocular infections. Pulmonary, sinus and disseminated infections and mortality were frequently reported in patients with S. boydii infection. Voriconazole's minimum inhibitory concentration was low for S. boydii, S. apiospermum and S. aurantiacum. Caspofungin, micafungin and anidulafungin were active against S. boydii and S. apiospermum. A potentially novel Scedosporium species was identified in this study, with distinct clinical manifestations and antifungal susceptibility.ConclusionsAt our centre, S. boydii is the main causative species of scedosporiosis; voriconazole could be the first‐line treatment in Taiwan. Our study supports the importance of speciation, rather than only categorising these isolates into S. apiospermum species complex.

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