2014 - Transplant Infectious Disease Conference

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Pesky Pathogens: Mycobacteria and Fungi

2.3 - Scedosporium

Presenter: Patricia, Munoz, Madrid, Spain
Authors: Patricia Munoz

Scedosporium spp. is a difficult to treat filamentous fungi that may cause very aggressive disease in transplantation recipients. It is ubiquitous and can be recovered from the environment (soil, polluted water, vegetation, etc). In some series S. apiospermum was responsible for 25% of invasive mycoses caused by filamentous fungi other than Aspergillus. Scedosporium may cause a wide spectrum of infections, but in the transplant population disseminated or deep-seated infections with a common skin, sinuses, lungs, and central nervous system involvement are especially worrying. Histopathological findings (septate, branching, hyaline hyphae) are similar to those of aspergillosis, so culture is usually necessary to confirm the identification. This species may be easily recovered from blood cultures. Voriconazole is the first line therapy for the susceptible species, but S. prolificans is uniformly resistant to all common antifungals. Surgery must be considered if feasible.

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