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Myocarditis and brain abscess caused by disseminated Scedosporium boydii infection.
Jackson, Devon L; Coke, Lamarque; Zhang, Sean X; Steenbergen, Charles; Khan, Galam; Gorfu, Gezahegn; Mitchell, Roger A.
Afiliación
  • Jackson DL; Howard University Hospital, Department of Pathology, 2041 Georgia Ave NW, Washington, DC 20060, USA. Electronic address: devon.l.jackson86@gmail.com.
  • Coke L; Howard University College of Medicine, 520 W St NW, Washington, DC 20059, USA.
  • Zhang SX; Johns Hopkins Hospital, Division of Medical Microbiology, Department of Pathology, 600 North Wolfe Street, Meyer B1-125A, Baltimore, MD 21287, USA.
  • Steenbergen C; Johns Hopkins Hospital, Division of Cardiovascular Pathology, 632N Ross Building, 720 Rutland Avenue, Baltimore, MD 21205, USA.
  • Khan G; MedStar Health/Georgetown University Medical Center, Department of Neurology, 4000 Reservoir Rd NW, Bldg D, Room 333/335, Washington, DC 20007, USA.
  • Gorfu G; Howard University Hospital, Department of Pathology, 2041 Georgia Ave NW, Washington, DC 20060, USA.
  • Mitchell RA; Howard University Hospital, Department of Pathology, 2041 Georgia Ave NW, Washington, DC 20060, USA.
J Natl Med Assoc ; 116(3): 238-246, 2024 Jun.
Article en En | MEDLINE | ID: mdl-38310044
ABSTRACT
Scedosporium spp. is a fungal species documented as the cause of infections involving the lungs, brain, and other organ systems in both immunocompetent and immunocompromised individuals. Many cases of this type of fungal infection occurring in immunocompetent patients are subsequent to traumatic injury or drowning events in or near waters containing the fungi. Infection commonly involves the lungs. Rarely, it has been shown to cause disease in the endocardium, but there is even less documentation of the fungi invading the myocardium and causing myocarditis. In this report, we present a case of disseminated Scedosporium boydii infection in a 52-year-old male patient without any known risk factors. He presented with acute onset chest pain and dyspnea accompanied by bilateral lower extremity edema. He was found to have new onset heart failure with reduced ejection fraction, and his hospital course was complicated by pneumonia, disseminated intravascular coagulation (DIC), and brain abscess formation. Multiple blood cultures failed to reveal the source of the infection. At autopsy, septated branching hyphae were identified invading both the myocardium and the cortical brain tissue. DNA sequencing revealed the fungal organisms to be Scedosporium boydii. This case reinforces the importance of autopsies in the clinical setting. It not only established the definitive diagnosis of an unexpected fungal infection, but it also helped to recognize new clinical and pathologic features of this particular fungal organism.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Absceso Encefálico / Scedosporium / Miocarditis Tipo de estudio: Prognostic_studies / Risk_factors_studies Límite: Humans / Male / Middle aged Idioma: En Revista: J Natl Med Assoc Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Absceso Encefálico / Scedosporium / Miocarditis Tipo de estudio: Prognostic_studies / Risk_factors_studies Límite: Humans / Male / Middle aged Idioma: En Revista: J Natl Med Assoc Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos