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Internal Medicine (Tokyo, Japan) 2016Scedosporium prolificans, a hyaline filamentous fungus, is widely distributed in the environment and is currently an emerging human pathogen, especially among... (Review)
Review
Scedosporium prolificans, a hyaline filamentous fungus, is widely distributed in the environment and is currently an emerging human pathogen, especially among immunocompromised patients. However, S. prolificans endocarditis is rare. We herein report a case of S. prolificans endocarditis in a 64-year-old patient with breast cancer in complete remission for 30 years after chemotherapy and radiation treatment who was not cured. Susceptibility testing showed resistance to all antifungal drugs, except echinocandin. A review of the literature revealed 10 cases of S. prolificans endocarditis; of these, only one involved an immunocompetent host with no risk factors and only two patients survived. In order to improve the mortality rate, it is necessary to establish rapid diagnostic methods and efficient therapeutic approaches.
Topics: Antifungal Agents; Breast Neoplasms; Echinocandins; Endocarditis; Fatal Outcome; Female; Humans; Immunocompromised Host; Middle Aged; Mycoses; Scedosporium
PubMed: 26726091
DOI: 10.2169/internalmedicine.55.5592 -
Internal Medicine Journal Aug 2023Scedosporium and Lomentospora species are environmental moulds that are virulent in immunocompromised hosts and rarely cause bloodstream infection (BSI). Patients with...
Scedosporium and Lomentospora species are environmental moulds that are virulent in immunocompromised hosts and rarely cause bloodstream infection (BSI). Patients with Scedosporium and Lomentospora species BSI were identified by the state public laboratory service in Queensland, Australia, over a 20-year period. Twenty-two incident episodes occurred among 21 residents; one patient had a second episode 321 days following the first. Of these, 18 were Lomentospora prolificans, three were Scedosporium apiospermum complex and one was a nonspeciated Scedosporium species. Seventeen (81%) patients died during their index admission, and all-cause mortality at 30, 90 and 365 days was 73%, 82% and 91% respectively. All 20 patients with haematological malignancy died within 365 days of follow-up with a median time to death of 9 days (interquartile range, 6-20 days) following diagnoses of BSI.
Topics: Adult; Female; Humans; Male; Middle Aged; Australia; Fungemia; Immunocompromised Host; Leukemia; Scedosporium
PubMed: 37599232
DOI: 10.1111/imj.16198 -
The Pediatric Infectious Disease Journal Nov 2016
Topics: Adolescent; Antifungal Agents; Drug Resistance, Fungal; Female; Humans; Mycoses; Naphthalenes; Otitis Externa; Rosaniline Dyes; Scedosporium; Terbinafine; Treatment Outcome; Voriconazole
PubMed: 27753775
DOI: 10.1097/INF.0000000000001291 -
Medical Mycology Jun 2009For the last ten years, non-Aspergillus mold species have been increasingly involved in human invasive infections, probably as a consequence of more intense... (Review)
Review
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.
Topics: Adult; Aged; Animals; France; Humans; Immunocompromised Host; Male; Mycoses; Scedosporium
PubMed: 19085456
DOI: 10.1080/13693780802454761 -
Emerging Infectious Diseases Jun 2024Scedosporium spp. and Lomentospora prolificans are emerging non-Aspergillus filamentous fungi. The Scedosporiosis/lomentosporiosis Observational Study we previously... (Observational Study)
Observational Study Review
Scedosporium spp. and Lomentospora prolificans are emerging non-Aspergillus filamentous fungi. The Scedosporiosis/lomentosporiosis Observational Study we previously conducted reported frequent fungal vascular involvement, including aortitis and peripheral arteritis. For this article, we reviewed 7 cases of Scedosporium spp. and L. prolificans arteritis from the Scedosporiosis/lomentosporiosis Observational Study and 13 cases from published literature. Underlying immunosuppression was reported in 70% (14/20) of case-patients, mainly those who had solid organ transplants (10/14). Osteoarticular localization of infection was observed in 50% (10/20) of cases; infections were frequently (7/10) contiguous with vascular infection sites. Scedosporium spp./Lomentospora prolificans infections were diagnosed in 9 of 20 patients ≈3 months after completing treatment for nonvascular scedosporiosis/lomentosporiosis. Aneurysms were found in 8/11 aortitis and 6/10 peripheral arteritis cases. Invasive fungal disease--related deaths were high (12/18 [67%]). The vascular tropism of Scedosporium spp. and L. prolificans indicates vascular imaging, such as computed tomography angiography, is needed to manage infections, especially for osteoarticular locations.
Topics: Humans; Scedosporium; France; Male; Middle Aged; Aged; Female; Mycoses; Adult; Antifungal Agents; Aged, 80 and over; Invasive Fungal Infections
PubMed: 38781681
DOI: 10.3201/eid3006.231409 -
Transplant Infectious Disease : An... Jun 2021Scedosporium apiospermum and Lomentospora prolificans (Scedosporium/Lomentospora) species are emerging, multi-resistant pathogens that cause life-threatening illnesses...
INTRODUCTION
Scedosporium apiospermum and Lomentospora prolificans (Scedosporium/Lomentospora) species are emerging, multi-resistant pathogens that cause life-threatening illnesses among lung transplant (LTx) recipients. The current epidemiology and management in LTx are unknown.
METHODS
We performed a retrospective single center audit of all sputum/bronchoscopy samples for Scedosporium/Lomentospora species in LTx patients over a 24-year period (1995-2019). Patients were diagnosed as colonized or with invasive fungal disease.
RESULTS
From a cohort of 962 LTx recipients, 30 patients (3.1%) cultured Scedosporium/Lomentospora (1.2%, 1.9%, respectively). There were no isolates from 1995 to 2013, with multiple yearly isolates thereafter. Nineteen (63%) cases were classified as IFD, and 11 (37%) as colonization. The median time to first culture from transplantation was 929 days (Interquartile-range [IQR] 263-2960). Most patients (63%) had received antifungals prior to the first positive culture of Scedosporium/Lomentospora for other fungal infection. The most common antifungal used for treatment of Scedosporium/Lomentospora was posaconazole (n = 16; 53%). Median duration of therapy was 364 days (IQR 164-616). Treatment was associated with improved lung function over 6 months (median FEV1 increased from 1.3L[IQR 0.9-1.8L] to 1.8L[IQR 1.1-2.3] P = .05). Six patients cultured Scedosporium/Lomentospora prior to transplantation, and no survival disadvantage was seen as compared to our whole LTx cohort (P = .8).
CONCLUSION
Our single center 24-year experience suggests that the incidence of Scedosporium/Lomentospora is increasing. Scedosporium/Lomentospora is typically isolated several years after LTx, and requires prolonged anti-fungal treatment that is usually associated with improved in lung function. Culture of Scedosporium/Lomentospora prior to LTx did not pose a survival disadvantage. Further surveillance is required to fully characterize implications of these organisms for LTx recipients.
Topics: Antifungal Agents; Humans; Lung Transplantation; Mycoses; Retrospective Studies; Scedosporium
PubMed: 33315292
DOI: 10.1111/tid.13546 -
Medical Mycology Jun 2009Scedosporium prolificans is one of the most life-threatening fungal opportunistic pathogens due to its high resistance to common systemic antifungal agents. While a... (Review)
Review
Scedosporium prolificans is one of the most life-threatening fungal opportunistic pathogens due to its high resistance to common systemic antifungal agents. While a close relative of Pseudallescheria boydii, S. prolificans has a more limited geographic range being primarily found in Australia, USA and Spain. Infections have also been reported from several other European countries and from Chile. Twenty patients with Scedosporium prolificans infection or colonization from August 1993 to May 2007 were retrospectively reviewed in Germany. They had all been identified at or reported to the Reference Laboratory for Pseudallescheria/Scedosporium spp. in Berlin. Twelve of 13 patients with haematological disorders and/or on immunosuppressive therapy developed a fatal invasive scedosporiosis. Colonization of the respiratory tract was reported for one patient after heart-lung-transplantation, all six patients with cystic fibrosis and one with chronic sinusitis. Molecular studies of the S. prolificans isolates confirmed that parts of the 18S, the Internal Transcribed Spacer (ITS) regions and the D1/D2 domain of the 28S region of rDNA are monomorphic. However, sequencing of parts of the translation elongation factor EF1-alpha (EF-1alpha) and the chitin synthase (CHS-1) genes revealed the presence of three and two distinct genotypes, respectively. Two informative mutations were found in EF-1alpha and a single nucleotide exchange in the CHS-1 gene.
Topics: Adolescent; Adult; Child; Chitin Synthase; DNA, Fungal; DNA, Ribosomal; DNA, Ribosomal Spacer; Female; Fungal Proteins; Germany; Hematologic Neoplasms; Humans; Immunocompromised Host; Immunosuppressive Agents; Male; Middle Aged; Mycoses; Peptide Elongation Factor 1; Phylogeny; Polymorphism, Genetic; RNA, Ribosomal, 28S; Scedosporium; Sequence Analysis, DNA; Young Adult
PubMed: 19301173
DOI: 10.1080/13693780802627440 -
Trends in Microbiology Dec 2019
Topics: Antifungal Agents; Cystic Fibrosis; Humans; Immunocompromised Host; Invasive Fungal Infections; Scedosporium; Soil Microbiology
PubMed: 31378439
DOI: 10.1016/j.tim.2019.07.003 -
The Canadian Journal of Infectious... Jan 1999Fungemia due to Scedosporium prolificans is described in a young woman with a relapse of acute lymphoblastic leukemia. Several days after starting reinduction...
Fungemia due to Scedosporium prolificans is described in a young woman with a relapse of acute lymphoblastic leukemia. Several days after starting reinduction chemotherapy, the patient presented with fever, neutropenia and blood cultures showing fungi on Gram stain. The patient died despite therapy with antifungal agents, including fluconazole and amphotericin B. Fungi grew from blood cultures, and was subsequently identified as Scedosporium prolificans.
PubMed: 22346375
DOI: 10.1155/1999/635193 -
Journal of Clinical Microbiology Aug 2003Scedosporium species are increasingly isolated from immunocompromised and immunocompetent patients. Unfortunately, Scedosporium infections are generally resistant to... (Review)
Review
Scedosporium species are increasingly isolated from immunocompromised and immunocompetent patients. Unfortunately, Scedosporium infections are generally resistant to amphotericin B, and Scedosporium prolificans strains are particularly resistant to the antifungal agents now in use. We report here on an immunocompetent child with S. prolificans-associated osteomyelitis successfully treated with debridement, local irrigation with polyhexamethylene biguanide, and the systemic administration of voriconazole and caspofungin despite poor in vitro activity of voriconazole alone against the isolate. We also review the treatments and outcomes of 28 reported cases of osteomyelitis or septic arthritis caused by Scedosporium species in immunocompetent patients.
Topics: Administration, Topical; Anti-Bacterial Agents; Antifungal Agents; Biguanides; Caspofungin; Child, Preschool; Disinfectants; Echinocandins; Humans; Lipopeptides; Magnetic Resonance Imaging; Male; Mucormycosis; Osteomyelitis; Peptides; Peptides, Cyclic; Pyrimidines; Scedosporium; Triazoles; Voriconazole
PubMed: 12904435
DOI: 10.1128/JCM.41.8.3981-3985.2003