Scedosporium infection B45.9

Rare, often lethal (opportunistic) mould infection in immunocompromised patients by S. prolificans and S. apiopspermum (anamorphic form; teleomorphic: Pseudallescheria boydii ).

Affected are mainly haemato-oncological patients and patients after solitary organ transplants (Caroti L et al. 2010). As a risk factor, the application of glucocorticoids is considered the most important. In recent years, the importance of colonization of the respiratory tract of patients with perennial cystic fibrosis (CF) has been increasingly pointed out and warned against lung transplantation in P. boydii colonized CF patients.

Localized manifestation with formation of fungal ganulomas in skin (formation of subcutaneous nodules), eye, joints and respiratory tract.

Generalized manifestation: Fungemia with fever, myalgia and hematogenic organ manifestation.

Voriconazole

Alternative: liposomal amphotericin B

For several decades, as in fusariosis, a change in infection localization from localized mycetic lesions in immunocompetent patients after traumatic pathogen inoculation to systemic and disseminated infections in immunocompromised patients has been observed.

1. Caroti L et al (2010) Subcutaneous nodules and infectious complications in renal allograft recipients. Transplant proc 42:1146-1147.
2. Solé A Scedosporium apiospermum disseminated infection in a single lung transplant recipient. Rev Iberoam Micol 28:139-142.