ABSTRACT
Resumen Scedosporium es un hongo de distribución mundial que se encuentra en el suelo y enaguas contaminadas. Raramente afecta tejido óseo y puede hacerlo por inoculación directa através de traumatismos. Se presenta el caso clínico de un paciente de 54 a˜nos con antecedentede accidente acuático y fractura expuesta de tibia-peroné de ambos miembros inferiores, condiagnóstico de osteomielitis crónica bacteriana tratada con antibióticos de amplio espectropor 120 días. Luego de ocho meses iniciado el cuadro, se aísla Scedosporium spp. en colecciónde miembro afectado; por tal motivo, el paciente recibe terapia con voriconazol asociado aterbinafina.© 2019 Asociacion Argentina de Microbiologıa. Publicado por Elsevier Espana, S.L.U. Este es unarticulo Open Access bajo la licencia CC BY-NC-ND (https://creativecommons.org/licenses/by-nc-nd/4.0/).
Abstract Scedosporium is a fungus that has a worldwide distribution, and which can be foundin soil and contaminated water. It can rarely affect bone tissue and can do it either by directinoculation or through trauma. We present here a case of a 54- year- old male patient with adiagnosis of chronic bacterial osteomyelitis due to an aquatic accident and exposed fracture of tibia-fibula of both members, which was treated with broad-spectrum antibiotics for 120days. Eight months after the onset of the disease, Scedosporium spp. was isolated from thecollection of one of the affected member, which was treated with voriconazole in combinationwith terbinafine.© 2019 Asociacion Argentina de Microbiologıa. Published by Elsevier Espana, S.L.U. This is anopen access article under the CC BY-NC-ND license (https://creativecommons.org/licenses/by-nc-nd/4.0/).
Subject(s)
Humans , Male , Middle Aged , Osteomyelitis/microbiology , Scedosporium/isolation & purification , Invasive Fungal InfectionsABSTRACT
We reported a case of non-invasive pulmonary infection by Scedosporium apiospermum in 67 years old female with bronchiectasis and caverns secondary to tuberculosis. Diagnosis was made with lung CT and bronchial lavage cultures. The patient was initially treated with itraconazole for six weeks without success and then voriconazole for 16 weeks, with good clinical response.
Reportamos el caso clínico de una infección pulmonar no invasora por Scedosporium apiospermum en una mujer de 67 años de edad, con bronquiectasias y cavernas pulmonares secundarias a una tuberculosis. El diagnóstico se realizó con la TAC pulmonar y cultivos de lavado bronquial. La paciente fue tratada inicialmente con itraconazol oral por seis semanas sin respuesta y luego voriconazol vía oral por 16 semanas, con una buena respuesta clínica.
Subject(s)
Aged , Female , Humans , Lung Diseases, Fungal/microbiology , Scedosporium/isolation & purification , Antifungal Agents/therapeutic use , Bronchoalveolar Lavage Fluid/microbiology , Lung Diseases, Fungal/drug therapy , Scedosporium/growth & development , Tomography, X-Ray Computed , Triazoles/therapeutic useABSTRACT
This study analyzed the recent causes, prognosis, and treatment strategies for fungal endophthalmitis. A retrospective review of patients who were diagnosed with fungal endophthalmitis at our center was conducted. The fungal organisms isolated from each patient and the visual prognosis according to the route of infection and treatment method were analyzed. A total of 40 eyes from 30 patients with fungal endophthalmitis were included in this study. Candida species were the most common causative organisms in 35 of 40 eyes. Endogenous and exogenous endophthalmitis were observed in 33 and 7 eyes, respectively. Pre- and post-treatment best-corrected visual acuity (BCVA) was not significantly different between endogenous endophthalmitis and exogenous endophthalmitis. The 40 eyes were treated using the following modalities: intravitreal antifungal agent injection with intravenous antifungal agent (16 eyes), vitrectomy with intravenous antifungal agent (14 eyes), intravenous antifungal agent alone (9 eyes), and evisceration (1 eye). Post-treatment BCVA only significantly improved after treatment in the vitrectomy group. Candida species were the most common cause of fungal endophthalmitis, irrespective of the route of infection. The visual prognosis of fungal endophthalmitis was generally poor. In conclusion, if the general condition of the patient tolerates a surgical procedure, prompt vitrectomy and intravitreal injection of antifungal agents can improve visual acuity.
Subject(s)
Humans , Antifungal Agents/therapeutic use , Aspergillus/isolation & purification , Candida/isolation & purification , Endophthalmitis/drug therapy , Eye Infections, Fungal , Fusarium/isolation & purification , Prognosis , Republic of Korea , Retrospective Studies , Scedosporium/isolation & purification , Tertiary Care Centers , Visual Acuity , VitrectomyABSTRACT
El complejo Pseudallescheria/Scedosporium y taxas relacionados, pertenecientes a un grupo de microhongos con conidios viscosos e integrantes del orden Microascales, se presentan en diversos ambientes comunes asociados a las actividades humanas, ya sea en el suelo como en aguas contaminadas. Actualmente se consideran entre los mayores grupos de hongos filamentosos oportunistas causante de infecciones cutáneas y profundas en el hombre y otros mamíferos. El objetivo principal de este trabajo, consiste en reunir los datos primarios morfofisiológicos más relevantes, útiles para el micólogo médico en el laboratorio, con el aporte adicional de algunos aspectos, biológicos, ecológicos, taxonómicos y moleculares complementarios descritos en la literatura moderna.
The Pseudallescheria/Scedosporium complex and their related taxa are a group of fungus that conidia are presents in viscous mass and belong to the order Microascales. They are in several common enviroment related to human activities either in soil as in contaminated water. Nowadays they are considerated one of the most opportunistic group of filamentous fungus that may cause superficial and deep skin mycoses infections in man and other mammalian. The aim of this work is to gather the primary relevant morphophysiological aspects, usefull to the medical mycologist in the laboratory, plus the contribution of some of biological, ecological, taxonomical and moleculars complementary aspects that are describe in modern literature.
Subject(s)
Dermatomycoses , Mycoses , Pseudallescheria/isolation & purification , Pseudallescheria/cytology , Pseudallescheria/classification , Pseudallescheria/physiology , Scedosporium/isolation & purification , Scedosporium/cytology , Scedosporium/classification , Scedosporium/physiologyABSTRACT
Scedosporium species can cause colonization, superficial and deep localized infection or systemic disease, espe-cially in irnmunocompromised hosts. We report a case of localized infection due to Scedosporium apiospermum in a 47 year oíd woman, with previous nasal surgery. She consulted for recurrent mucopurulent post-nasal discharge not responding to antibiotics. Computed tomography showed opacification of right maxillary sinus. Surgery was performed to removed abnormal tissue from sinus; biopsy revealed chronic sinusitis with aggregate of tightly packed hyphae suggestive of filamentous fungi. The microbiology fungal culture reported Scedosporium apiospermum.
Las infecciones por Scedosporium sp pueden traducirse en colonización, infecciones localizadas superficiales y profundas, o enfermedad diseminada. Presentamos un caso clínico de infección rinosinusal por Scedosporium apiospermum en una paciente de 47 años, con antecedente de cirugía por cuerpo extraño en la fosa nasal derecha. Consultó por descarga posterior muco-purulenta y recurrente, sin respuesta a tratamiento antibacteriano. Las imágenes de cavidades paranasales mostraron opacidad del seno maxilar derecho. Se realizó cirugía de remoción de contenido sinusal cuyo estudio histológico reveló sinusitis crónica erosiva, colonias de hongos con morfología sugerente de hongo filamentoso y desarrollo de S. apiospermum en el cultivo.
Subject(s)
Female , Humans , Middle Aged , Immunocompetence , Mycetoma/microbiology , Rhinitis/microbiology , Scedosporium/isolation & purification , Sinusitis/microbiology , Chronic Disease , Mycetoma/diagnosis , Mycetoma/surgery , Rhinitis/diagnosis , Rhinitis/surgery , Sinusitis/diagnosis , Sinusitis/surgeryABSTRACT
Las infecciones fúngicas invasivas son una importante causa de morbimortalidad en los pacientes inmunocomprometidos. Diversos factores han producido, en los últimos años, un cambio en la epidemiología de éstas, con aislamiento de hongos infrecuentes hasta hace dos décadas (zygomicetos; Fusarium spp y Scedosporium spp), presentando un desafío diagnóstico y terapéutico. En este reporte describimos un paciente con diagnóstico reciente de VIH/sida, trabajador rural, con antecedentes de fiebre, diarrea y cuadro respiratorio, quien durante la internación presentó un cuadro de neutropenia febril, desarrollando una infección diseminada por Scedosporium prolificans, tratado con éxito con voriconazol.
Invasive fungal disease is a major cause of morbidity and mortality in immunocompromised patients. Over recent decades numerous factors have contributed to a change in the apidemiology of invasive mycoses. There have been increasing reports of infections due to new and emerging pathogens such as zygomycetes, Fusarium spp and Scedosporium spp, which pose a major diagnostic and therapeutic challenge...
Subject(s)
Humans , Male , Adult , Antifungal Agents/therapeutic use , Fungi , AIDS-Related Opportunistic Infections/complications , AIDS-Related Opportunistic Infections/mortality , Opportunistic Infections , Scedosporium/isolation & purification , Rural WorkersABSTRACT
Scedosporium apiospermum is a filamentous fungi that commonly causes cutaneous infection. In certain circumstances, S. apiospermum can also cause invasive disease, which can involve the central nervous system (CNS). When the CNS becomes involved, treatment is difficult, therapeutic options are limited and the prognosis is poor. Early identification and treatment can decrease the mortality rate. Here we present a case of brain abscess with chronic suppurative otitis media, caused by S. apiospermum. This is the first such case report from Nepal. We could identify the organism only post mortem. We could not save the patient, probably due to delay in diagnosis.
Subject(s)
Aminoglycosides/therapeutic use , Antifungal Agents/therapeutic use , Brain Abscess/diagnosis , Cephalosporins/therapeutic use , Child , Fatal Outcome , Female , Humans , Mycoses/diagnosis , Nepal , Otitis Media with Effusion/diagnosis , Scedosporium/isolation & purificationABSTRACT
Scedosporium apiospermum, the asexual state of Pseudallescheria boydii, is increasingly recognized as an opportunistic pathogen. We report a case of prosthetic valve endocarditis caused by this organism that developed in a patient following cardiac surgery.
Subject(s)
Adult , Endocarditis/microbiology , Heart Valve Prosthesis/adverse effects , Heart Ventricles/microbiology , Humans , Male , Prosthesis-Related Infections/microbiology , Scedosporium/isolation & purificationABSTRACT
São relatados quatro casos de colonização intracavitária (bola fúngica) do trato respiratório por Scedosporium apiospermum (teleomorfo, Pseudallescheria boydii). É enfatizada a necessidade de cuidadosa busca de aneloconídios, a fim de estabelecer o diagnóstico etiológico no espécime clínico, através da microscopia.