The Importance of a Proper Aetiological Diagnosis in the Management of Patients with Invasive Mycoses: A Case Report of a Brain Abscess by Scedosporium apiospermum

Caggiano, Giuseppina; Cantisani, Piero; Rolli, M.; Gianfreda, Cosimo Damiano; Pizzolante, M.; Montagna, Maria Teresa

doi:10.1007/s11046-011-9436-4

Cited by 11 publications

(6 citation statements)

References 16 publications

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“…The most common infection in fatal complications is aspergillosis in patients with hematological malignancies [ 15 ] and mucormycosis in patients with uncontrolled diabetes mellitus [ 16 ],[ 17 ]. Rare mold diseases, such as fusariosis and scedosporiosis, have also been described [ 18 ]-[ 20 ]. Filamentous fungal infections (FFIs) are serious postoperative complications in transplant recipients [ 21 ],[ 22 ], requiring particular attention by the clinician and surgeon.…”

Section: Introductionmentioning

confidence: 99%

Mold contamination in a controlled hospital environment: a 3-year surveillance in southern Italy

et al. 2014

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BackgroundEnvironmental monitoring of airborne filamentous fungi is necessary to reduce fungal concentrations in operating theaters and in controlled environments, and to prevent infections. The present study reports results of a surveillance of filamentous fungi carried out on samples from air and surfaces in operating theaters and controlled environments in an Italian university hospital.MethodsSampling was performed between January 2010 and December 2012 in 32 operating theaters and five departments with high-risk patients. Indoor air specimens were sampled using a microbiological air sampler; Rodac contact plates were used for surface sampling. Fungal isolates were identified at the level of genera and species.ResultsSixty-one samples (61/465; 13.1%) were positive for molds, with 18 from controlled environments (18/81; 22.2%) and 43 (43/384; 11.2%) from operating theaters. The highest air fungal load (AFL, colony-forming units per cubic meter [CFU/m3]) was recorded in the ophthalmology operating theater, while the pediatric onco-hematology ward had the highest AFL among the wards (47 CFU/m3). The most common fungi identified from culture of air specimens were Aspergillus spp. (91.8%), Penicillium spp., (6%) and Paecilomyces spp. (1.5%). During the study period, a statistically significant increase in CFU over time was recorded in air-controlled environments (p = 0.043), while the increase in AFL in operating theaters was not statistically significant (p = 0.145). Molds were found in 29.1% of samples obtained from surfaces. Aspergillus fumigatus was the most commonly isolated (68.5%).ConclusionsOur findings will form the basis for action aimed at improving the air and surface quality of these special wards. The lack of any genetic analysis prevented any correlation of fungal environmental contamination with onset of fungal infection, an analysis that will be undertaken in a prospective study in patients admitted to the same hospital.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-014-0595-z) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

Mold contamination in a controlled hospital environment: a 3-year surveillance in southern Italy

et al. 2014

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“…Indeed, although most FFIs are attributed to the Aspergillus genus, other less common molds, such as Mucorales , Fusarium and Scedosporium spp, are increasingly reported [16–18]. …”

Section: Introductionmentioning

confidence: 99%

SIMIFF study: Italian fungal registry of mold infections in hematological and non-hematological patients

et al. 2013

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PurposeWe compared the risk factors, the diagnostic tools and the outcome of filamentous fungal infections (FFIs) in hematological patients (HAEs) and non-hematological patients (non-HAEs).MethodsProspective surveillance (2009–2011) of proven and probable FFIs was implemented in 23 Italian hospitals.ResultsOut of 232 FFIs, 113 occurred in HAEs and 119 in non-HAEs. The most frequent infection was invasive aspergillosis (76.1 % for HAEs, 56.3 % for non-HAEs), and the localization was principally pulmonary (83.2 % for HAEs, 74.8 % for non-HAEs). Neutropenia was a risk factor for 89.4 % HAEs; the main underlying condition was corticosteroid treatment (52.9 %) for non-HAEs. The distribution of proven and probable FFIs was different in the two groups: proven FFIs occurred more frequently in non-HAEs, whereas probable FFIs were correlated with the HAEs. The sensitivity of the galactomannan assay was higher for HAEs than for non-HAEs (95.3 vs. 48.1 %). The overall mortality rate was 44.2 % among the HAEs and 35.3 % among the non-HAEs. The etiology influenced the patient outcomes: mucormycosis was associated with a high mortality rate (57.1 % for HAEs, 77.8 % for non-HAEs).ConclusionsThe epidemiological and clinical data for FFIs were not identical in the HAEs and non-HAEs. The differences should be considered to improve the management of FFIs according to the patients’ setting.

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“…As the clinical and histopathological presentations of S. apiospermum infections are similar to those of other fungi such as Aspergillus and Fusarium spp., a culture is necessary for accurate diagnosis. Furthermore, while most species of Aspergillus (except for Aspergillus terreus) are sensitive to amphotericin, S. apiospermum is usually resistant 15 . In addition, PCR techniques are important to diagnose as well as to distinguish between different species 16 .…”

Section: Discussionmentioning

confidence: 99%

Antifungal therapy and surgical drainage for the treatment of a cerebral abscess caused by Scedosporium apiospermum in a renal transplant patient - a case report

et al. 2014

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Abstractthe asexual form of , is a Scedosporium apiospermum, Pseudallescheria boydii filamentous, opportunistic fungus which can be found in environmental sources all over the world. It is a human pathogen mostly associated with lung, bone and joint infections and less frequently with infections of the central nervous system (CNS). The latter is generally related to the patient's immune state, and occurs most frequently in immunocompromised patients. We present the case of a 64-year-old male patient with a background of chronic kidney failure secondary to nephroangiosclerosis and a renal transplantation who presented with left-sided hemiplegia and dysarthria. A brain MRI revealed a hyperintense lesion with ring enhancement at the right paramedian posterior frontal subcortical area with an associated vasogenic edema. A stereotactic biopsy of the lesion revealed the presence of . The patient received a S. apiospermum combined therapy of voriconazole and terbinafine with surgical drainage, which led to temporarily clinical and radiological improvement.

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The Importance of a Proper Aetiological Diagnosis in the Management of Patients with Invasive Mycoses: A Case Report of a Brain Abscess by Scedosporium apiospermum

Cited by 11 publications

References 16 publications

Mold contamination in a controlled hospital environment: a 3-year surveillance in southern Italy

Mold contamination in a controlled hospital environment: a 3-year surveillance in southern Italy

SIMIFF study: Italian fungal registry of mold infections in hematological and non-hematological patients

Antifungal therapy and surgical drainage for the treatment of a cerebral abscess caused by Scedosporium apiospermum in a renal transplant patient - a case report

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