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Neoh CF, Chen SCA, Lanternier F, Tio SY, Halliday CL, Kidd SE, Kong DCM, Meyer W, Hoenigl M, Slavin MA. Scedosporiosis and lomentosporiosis: modern perspectives on these difficult-to-treat rare mold infections. Clin Microbiol Rev 2024; 37:e0000423. [PMID: 38551323 DOI: 10.1128/cmr.00004-23] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2024] Open
Abstract
SUMMARYAlthough Scedosporium species and Lomentospora prolificans are uncommon causes of invasive fungal diseases (IFDs), these infections are associated with high mortality and are costly to treat with a limited armamentarium of antifungal drugs. In light of recent advances, including in the area of new antifungals, the present review provides a timely and updated overview of these IFDs, with a focus on the taxonomy, clinical epidemiology, pathogenesis and host immune response, disease manifestations, diagnosis, antifungal susceptibility, and treatment. An expansion of hosts at risk for these difficult-to-treat infections has emerged over the last two decades given the increased use of, and broader population treated with, immunomodulatory and targeted molecular agents as well as wider adoption of antifungal prophylaxis. Clinical presentations differ not only between genera but also across the different Scedosporium species. L. prolificans is intrinsically resistant to most currently available antifungal agents, and the prognosis of immunocompromised patients with lomentosporiosis is poor. Development of, and improved access to, diagnostic modalities for early detection of these rare mold infections is paramount for timely targeted antifungal therapy and surgery if indicated. New antifungal agents (e.g., olorofim, fosmanogepix) with novel mechanisms of action and less cross-resistance to existing classes, availability of formulations for oral administration, and fewer drug-drug interactions are now in late-stage clinical trials, and soon, could extend options to treat scedosporiosis/lomentosporiosis. Much work remains to increase our understanding of these infections, especially in the pediatric setting. Knowledge gaps for future research are highlighted in the review.
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Affiliation(s)
- Chin Fen Neoh
- National Centre for Infections in Cancer, Peter MacCallum Cancer Centre, Melbourne, Australia
- Department of Infectious Diseases, Peter MacCallum Cancer Centre, Melbourne, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Australia
| | - Sharon C-A Chen
- Centre for Infectious Diseases and Microbiology Laboratory Services, New South Wales Health Pathology, Westmead Hospital, Sydney, Australia
- The University of Sydney, Sydney, Australia
- Department of Infectious Diseases, Westmead Hospital, Sydney, Australia
| | - Fanny Lanternier
- Service de Maladies Infectieuses et Tropicales, Hôpital universitaire Necker-Enfants malades, Paris, France
- National Reference Center for Invasive Mycoses and Antifungals, Translational Mycology research group, Mycology Department, Institut Pasteur, Université Paris Cité, Paris, France
| | - Shio Yen Tio
- National Centre for Infections in Cancer, Peter MacCallum Cancer Centre, Melbourne, Australia
- Department of Infectious Diseases, Peter MacCallum Cancer Centre, Melbourne, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Australia
| | - Catriona L Halliday
- Centre for Infectious Diseases and Microbiology Laboratory Services, New South Wales Health Pathology, Westmead Hospital, Sydney, Australia
| | - Sarah E Kidd
- National Mycology Reference Centre, SA Pathology, Adelaide, Australia
- School of Biological Sciences, Faculty of Sciences, University of Adelaide, Adelaide, Australia
| | - David C M Kong
- National Centre for Infections in Cancer, Peter MacCallum Cancer Centre, Melbourne, Australia
- The National Centre for Antimicrobial Stewardship, The Peter Doherty Institute for Infections and Immunity, Melbourne, Australia
- Centre for Medicine Use and Safety, Monash Institute of Pharmaceutical Sciences, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Australia
- School of Medicine, Deakin University, Waurn Ponds, Geelong, Australia
| | - Wieland Meyer
- The University of Sydney, Sydney, Australia
- Westerdijk Fungal Biodiversity Institute, Utrecht, the Netherlands
| | - Martin Hoenigl
- Division of Infectious Diseases, Department of Internal Medicine, Medical University of Graz, Graz, Austria
- Translational Medical Mycology Research Group, ECMM Excellence Center for Clinical Mycology, Medical University of Graz, Graz, Austria
| | - Monica A Slavin
- National Centre for Infections in Cancer, Peter MacCallum Cancer Centre, Melbourne, Australia
- Department of Infectious Diseases, Peter MacCallum Cancer Centre, Melbourne, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Australia
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2
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Vignals C, Emmerich J, Begueret H, Garcia-Hermoso D, Martin-Blondel G, Angoulvant A, Blez D, Bruneval P, Cassaing S, Catherinot E, Cahen P, Moluçon-Chabrot C, Chevenet C, Delhaes L, Escaut L, Faruch M, Grenouillet F, Larosa F, Limousin L, Longchampt E, Mellot F, Nourrisson C, Bougnoux ME, Lortholary O, Roux A, Rozenblum L, Puges M, Lanternier F, Bronnimann D. Deciphering Unexpected Vascular Locations of Scedosporium spp. and Lomentospora prolificans Fungal Infections, France. Emerg Infect Dis 2024; 30:1077-1087. [PMID: 38781681 PMCID: PMC11138966 DOI: 10.3201/eid3006.231409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024] Open
Abstract
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.
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Gamaletsou MN, Rammaert B, Brause B, Bueno MA, Dadwal SS, Henry MW, Katragkou A, Kontoyiannis DP, McCarthy MW, Miller AO, Moriyama B, Pana ZD, Petraitiene R, Petraitis V, Roilides E, Sarkis JP, Simitsopoulou M, Sipsas NV, Taj-Aldeen SJ, Zeller V, Lortholary O, Walsh TJ. Osteoarticular Mycoses. Clin Microbiol Rev 2022; 35:e0008619. [PMID: 36448782 PMCID: PMC9769674 DOI: 10.1128/cmr.00086-19] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Osteoarticular mycoses are chronic debilitating infections that require extended courses of antifungal therapy and may warrant expert surgical intervention. As there has been no comprehensive review of these diseases, the International Consortium for Osteoarticular Mycoses prepared a definitive treatise for this important class of infections. Among the etiologies of osteoarticular mycoses are Candida spp., Aspergillus spp., Mucorales, dematiaceous fungi, non-Aspergillus hyaline molds, and endemic mycoses, including those caused by Histoplasma capsulatum, Blastomyces dermatitidis, and Coccidioides species. This review analyzes the history, epidemiology, pathogenesis, clinical manifestations, diagnostic approaches, inflammatory biomarkers, diagnostic imaging modalities, treatments, and outcomes of osteomyelitis and septic arthritis caused by these organisms. Candida osteomyelitis and Candida arthritis are associated with greater events of hematogenous dissemination than those of most other osteoarticular mycoses. Traumatic inoculation is more commonly associated with osteoarticular mycoses caused by Aspergillus and non-Aspergillus molds. Synovial fluid cultures are highly sensitive in the detection of Candida and Aspergillus arthritis. Relapsed infection, particularly in Candida arthritis, may develop in relation to an inadequate duration of therapy. Overall mortality reflects survival from disseminated infection and underlying host factors.
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Affiliation(s)
- Maria N. Gamaletsou
- Laiko General Hospital of Athens and Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Blandine Rammaert
- Université de Poitiers, Faculté de médecine, CHU de Poitiers, INSERM U1070, Poitiers, France
| | - Barry Brause
- Hospital for Special Surgery, Weill Cornell Medicine, New York, New York, USA
| | - Marimelle A. Bueno
- Far Eastern University-Dr. Nicanor Reyes Medical Foundation, Manilla, Philippines
| | | | - Michael W. Henry
- Hospital for Special Surgery, Weill Cornell Medicine, New York, New York, USA
| | - Aspasia Katragkou
- Nationwide Children’s Hospital, Columbus, Ohio, USA
- The Ohio State University School of Medicine, Columbus, Ohio, USA
| | | | - Matthew W. McCarthy
- Weill Cornell Medicine of Cornell University, New York, New York, USA
- New York Presbyterian Hospital, New York, New York, USA
| | - Andy O. Miller
- Hospital for Special Surgery, Weill Cornell Medicine, New York, New York, USA
| | | | - Zoi Dorothea Pana
- Hippokration General Hospital, Aristotle University School of Health Sciences, Thessaloniki, Greece
- Faculty of Medicine, Aristotle University School of Health Sciences, Thessaloniki, Greece
| | - Ruta Petraitiene
- Weill Cornell Medicine of Cornell University, New York, New York, USA
| | | | - Emmanuel Roilides
- Hippokration General Hospital, Aristotle University School of Health Sciences, Thessaloniki, Greece
- Faculty of Medicine, Aristotle University School of Health Sciences, Thessaloniki, Greece
| | | | - Maria Simitsopoulou
- Hippokration General Hospital, Aristotle University School of Health Sciences, Thessaloniki, Greece
- Faculty of Medicine, Aristotle University School of Health Sciences, Thessaloniki, Greece
| | - Nikolaos V. Sipsas
- Laiko General Hospital of Athens and Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Valérie Zeller
- Groupe Hospitalier Diaconesses-Croix Saint-Simon, Paris, France
| | - Olivier Lortholary
- Université de Paris, Faculté de Médecine, APHP, Hôpital Necker-Enfants Malades, Paris, France
- Institut Pasteur, Unité de Mycologie Moléculaire, CNRS UMR 2000, Paris, France
| | - Thomas J. Walsh
- Hospital for Special Surgery, Weill Cornell Medicine, New York, New York, USA
- Weill Cornell Medicine of Cornell University, New York, New York, USA
- New York Presbyterian Hospital, New York, New York, USA
- Center for Innovative Therapeutics and Diagnostics, Richmond, Virginia, USA
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4
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Budohoski KP, Raygor K, Cook D, Henrich T, Abla AA. Rapid sequential development and rupture of mycotic aneurysms within a period of days in a patient with graft-versus-host disease and angiotropic Scedosporium apiospermum infection. Surg Neurol Int 2022; 13:242. [PMID: 35855168 PMCID: PMC9282729 DOI: 10.25259/sni_970_2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 05/18/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Fungal origin mycotic aneurysms are rare and carry a high mortality rate. Scedosporium apiospermum is an ubiquitous fungus which has been described to cause devastating infections in immunocompromised hosts. Case Description: We report a case of a 23-year-old patient with Burkitt’s lymphoma and graft-versus-host disease admitted with intracerebral hemorrhage and sequential development of 12 anterior circulation aneurysms from disseminated Scedosporium infection. Despite aggressive surgical and antimicrobial treatment, the patient died 6 months later from multiorgan failure. The notable feature of this case is the rapid angioinvasiveness of the infection with new aneurysm formation within days of clear angiographic imaging despite the apparent lack of skull base osteomyelitis. Conclusion: We highlight the difficulties in treating fungal mycotic aneurysms and the associated high mortality. While a less aggressive approach might have been appropriate given the known poor outcomes, the age of the patients as well as the family wishes dictated the treatment decisions.
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Affiliation(s)
- Karol P. Budohoski
- Department of Neurosurgery, University of California San Francisco, San Francisco, California, Unites States
| | - Kunal Raygor
- Department of Neurosurgery, University of California San Francisco, San Francisco, California, Unites States
| | - Dan Cook
- Department of Radiology, University of California San Francisco, San Francisco, California, Unites States
| | - Timothy Henrich
- Department of Medicine, Division of HIV, Infectious Diseases, and Global Medicine, University of California San Francisco, San Francisco, California, Unites States
| | - Adib A. Abla
- Department of Neurosurgery, University of California San Francisco, San Francisco, California, Unites States
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5
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Schapira RS, Skabelund AJ, Upton RJ, Hua T, Xia H, Morris MJ. Aortic Mycetoma From Disseminated Cunninghamella Species Infection. Mil Med 2021; 185:e919-e922. [PMID: 31665398 DOI: 10.1093/milmed/usz363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Cunninghamella species are aggressive, opportunistic fungi that are becoming more commonly reported in immunocompromised patients. We present a case of disseminated Cunninghamella sp. infection after stem cell transplant for refractory multiple myeloma with formation of bilateral pleural effusions and an aortic mycetoma. PCR analysis of the patient's aortic mycetoma demonstrated a 90% match to Cunninghamella spp. This case illustrates the potential for severe opportunistic fungal infections in immunocompromised patients that can mimic other disease processes and result in an accelerated demise.
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Affiliation(s)
- Rebecca S Schapira
- Department of Allergy/Immunology, Mike O'Callaghan Military Medical Center, 4700 Las Vegas Blvd N, Nellis AFB, NV 89191
| | - Andrew J Skabelund
- Pulmonary Disease Clinic, Wilford Hall Ambulatory Surgical Center, 1 Wilford Hall Loop, JBSA-Lackland, TX 78236
| | | | - Tho Hua
- Center for Advanced Molecular Detection, Science and Technology, 2200 Bergquist Drive, JBSA-Lackland, Seoul, South Korea, TX 78236
| | - Hui Xia
- Center for Advanced Molecular Detection, Science and Technology, 2200 Bergquist Drive, JBSA-Lackland, Seoul, South Korea, TX 78236
| | - Michael J Morris
- Pulmonary/Critical Care Service, Department of Medicine, Brooke Army Medical Center, JBSA-Fort Sam Houston, TX 78234
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6
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Takata S, Tamase A, Hayashi Y, Anzawa K, Shioya A, Iinuma Y, Iizuka H. Ruptured fungal aneurysm of the peripheral middle cerebral artery caused by Lomentospora infection: A case report and literature review. INTERDISCIPLINARY NEUROSURGERY 2020. [DOI: 10.1016/j.inat.2020.100743] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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7
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Diffuse inflammatory aneurysmal aortitis secondary to Scedosporium apiospermum complex in an immunocompetent individual. Pathology 2019; 51:316-318. [PMID: 30819537 DOI: 10.1016/j.pathol.2018.10.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 10/21/2018] [Accepted: 10/29/2018] [Indexed: 11/21/2022]
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8
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Seidel D, Meißner A, Lackner M, Piepenbrock E, Salmanton-García J, Stecher M, Mellinghoff S, Hamprecht A, Durán Graeff L, Köhler P, Cheng MP, Denis J, Chedotal I, Chander J, Pakstis DL, Los-Arcos I, Slavin M, Montagna MT, Caggiano G, Mares M, Trauth J, Aurbach U, Vehreschild MJGT, Vehreschild JJ, Duarte RF, Herbrecht R, Wisplinghoff H, Cornely OA. Prognostic factors in 264 adults with invasive Scedosporium spp. and Lomentospora prolificans infection reported in the literature and FungiScope®. Crit Rev Microbiol 2019; 45:1-21. [DOI: 10.1080/1040841x.2018.1514366] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Danila Seidel
- Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany
- Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
| | - Arne Meißner
- Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany
- Department of Hospital Hygiene and Infection Control, University Hospital Cologne, Cologne, Germany
| | - Michaela Lackner
- Division of Hygiene and Medical Microbiology, Medical University of Innsbruck (MUI), Innsbruck, Austria
| | - Ellen Piepenbrock
- Department of Immunology and Hygiene, Institute for Medical Microbiology, University of Cologne, Cologne, Germany
| | - Jon Salmanton-García
- Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany
| | - Melanie Stecher
- Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany
- Partner site Bonn - Cologne, German Centre for Infection Research (DZIF), Cologne, Germany
| | - Sibylle Mellinghoff
- Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany
| | - Axel Hamprecht
- Division of Hygiene and Medical Microbiology, Medical University of Innsbruck (MUI), Innsbruck, Austria
| | - Luisa Durán Graeff
- Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany
| | - Philipp Köhler
- Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany
- Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
- Partner site Bonn - Cologne, German Centre for Infection Research (DZIF), Cologne, Germany
| | - Matthew P. Cheng
- Division of Infectious Diseases and Department of Medical Microbiology, McGill University Health Centre, Montreal, Canada
| | - Julie Denis
- Hôpitaux Universitaires, Department of Parasitology and Mycology, Plateau Technique de Microbiologie, FMTS, Université de Strasbourg, Strasbourg, France
| | - Isabelle Chedotal
- Oncology and Hematology Department, University Hospital of Strasbourg and INSERM U1113, Strasbourg, France
| | - Jagdish Chander
- Department of Microbiology, Government Medical College Hospital, Chandigarh, India
| | | | - Ibai Los-Arcos
- Infectious Diseases Department, Hospital Universitari Vall d’Hebron, Barcelona, Spain
| | - Monica Slavin
- University of Melbourne, Melbourne, Australia, The National Centre for Infections in Cancer, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Maria Teresa Montagna
- Department of Biomedical Sciences and Human Oncology, University of Bari Aldo Moro, Bari, Italy
| | - Giuseppina Caggiano
- Department of Biomedical Sciences and Human Oncology, University of Bari Aldo Moro, Bari, Italy
| | - Mihai Mares
- Laboratory of Antimicrobial Chemotherapy, Ion Ionescu de la Brad University, Iași, Romania
| | - Janina Trauth
- Medical Clinic II – Infectious Diseases, University Hospital Giessen/Marburg, Giessen, Germany
| | - Ute Aurbach
- Laboratory Dr. Wisplinghoff, Cologne, Germany
| | - Maria J. G. T. Vehreschild
- Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany
- Partner site Bonn - Cologne, German Centre for Infection Research (DZIF), Cologne, Germany
- Center for Integrated Oncology CIO Köln/Bonn, Medical Faculty, University of Cologne, Cologne, Germany
| | - Jörg Janne Vehreschild
- Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany
- Partner site Bonn - Cologne, German Centre for Infection Research (DZIF), Cologne, Germany
- Center for Integrated Oncology CIO Köln/Bonn, Medical Faculty, University of Cologne, Cologne, Germany
| | - Rafael F. Duarte
- Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
| | - Raoul Herbrecht
- Oncology and Hematology Department, University Hospital of Strasbourg and INSERM U1113, Strasbourg, France
| | - Hilmar Wisplinghoff
- Department of Immunology and Hygiene, Institute for Medical Microbiology, University of Cologne, Cologne, Germany
- Laboratory Dr. Wisplinghoff, Cologne, Germany
- Institute for Virology and Clinical Microbiology, Witten/Herdecke University, Witten, Germany
| | - Oliver A. Cornely
- Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany
- Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
- Partner site Bonn - Cologne, German Centre for Infection Research (DZIF), Cologne, Germany
- Center for Integrated Oncology CIO Köln/Bonn, Medical Faculty, University of Cologne, Cologne, Germany
- Clinical Trials Centre Cologne (ZKS Köln), University of Cologne, Cologne, Germany
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9
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Ragulojan R, Grupke S, Fraser JF. Systematic Review of Endovascular, Surgical, and Conservative Options for Infectious Intracranial Aneurysms and Cardiac Considerations. J Stroke Cerebrovasc Dis 2018; 28:838-844. [PMID: 30594429 DOI: 10.1016/j.jstrokecerebrovasdis.2018.11.035] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 11/23/2018] [Accepted: 11/30/2018] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION With rising rates of intravenous drug use, Infectious Intracranial aneurysms (IIAs) are a relevant topic for investigation. We performed a systematic review to better understand current practice patterns and limits of current published literature. METHOD 131 publications with a total of 499 patients (665 aneurysms) were included. Of the 499 patients, 83 were single case reports, and 20.5% of the total had multiple aneurysms. 35.8% of all aneurysms were ruptured. Of those reporting treatment, options included conservative antibiotic therapy (30.0%), open surgical intervention (31.1%), and endovascular occlusion (31.8%). Chronologically, publication of IIAs has increased. Usage of endovascular therapies has grown, while conservative and surgical management have declined in the literature. Overall, 56.2% of aneurysms for which conservative therapy was initiated eventually either underwent intervention or death of patient occurred. RESULTS The issue of cardiac valve surgery in relationship to aneurysm therapy was discussed in 20.8% (80 patients) of all 384 infectious endocarditis patients; of which 15.0% (12) underwent valve surgery before aneurysm treatment and 85.0 patients (68)% underwent valve surgery after aneurysm treatment. For 51 of the patients where valve surgery followed aneurysm management, the corresponding aneurysm treatment modality could be determined; 58.8% (30) of whom were managed endovascularly. 32.7% (26) of all cases reporting cardiac surgery details underwent cardiac surgery during their admission with the IIA. CONCLUSIONS Overall, increasing trend of endovascular management of IIAs is evident, and a strong temporal preference exhibited by providers to perform cardiac surgery subsequently to IIA management.
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Affiliation(s)
- Ranjan Ragulojan
- UK College of Medicine, University of Kentucky, Lexington, Kentucky.
| | - Stephen Grupke
- Department of Neurosurgery, College of Medicine, University of Kentucky, Lexington, Kentucky; Department of Radiology, College of Medicine, University of Kentucky, Lexington, Kentucky
| | - Justin F Fraser
- Department of Neurosurgery, College of Medicine, University of Kentucky, Lexington, Kentucky; Department of Radiology, College of Medicine, University of Kentucky, Lexington, Kentucky; Department of Neurology, College of Medicine, University of Kentucky, Lexington, Kentucky; Department of Neuroscience, College of Medicine, University of Kentucky, Lexington, Kentucky
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10
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Ramirez-Garcia A, Pellon A, Rementeria A, Buldain I, Barreto-Bergter E, Rollin-Pinheiro R, de Meirelles JV, Xisto MIDS, Ranque S, Havlicek V, Vandeputte P, Govic YL, Bouchara JP, Giraud S, Chen S, Rainer J, Alastruey-Izquierdo A, Martin-Gomez MT, López-Soria LM, Peman J, Schwarz C, Bernhardt A, Tintelnot K, Capilla J, Martin-Vicente A, Cano-Lira J, Nagl M, Lackner M, Irinyi L, Meyer W, de Hoog S, Hernando FL. Scedosporium and Lomentospora: an updated overview of underrated opportunists. Med Mycol 2018. [PMID: 29538735 DOI: 10.1093/mmy/myx113] [Citation(s) in RCA: 156] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Species of Scedosporium and Lomentospora are considered as emerging opportunists, affecting immunosuppressed and otherwise debilitated patients, although classically they are known from causing trauma-associated infections in healthy individuals. Clinical manifestations range from local infection to pulmonary colonization and severe invasive disease, in which mortality rates may be over 80%. These unacceptably high rates are due to the clinical status of patients, diagnostic difficulties, and to intrinsic antifungal resistance of these fungi. In consequence, several consortia have been founded to increase research efforts on these orphan fungi. The current review presents recent findings and summarizes the most relevant points, including the Scedosporium/Lomentospora taxonomy, environmental distribution, epidemiology, pathology, virulence factors, immunology, diagnostic methods, and therapeutic strategies.
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Affiliation(s)
- Andoni Ramirez-Garcia
- Fungal and Bacterial Biomics Research Group, Department of Immunology, Microbiology and Parasitology, Faculty of Science and Technology, University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Aize Pellon
- Fungal and Bacterial Biomics Research Group, Department of Immunology, Microbiology and Parasitology, Faculty of Science and Technology, University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Aitor Rementeria
- Fungal and Bacterial Biomics Research Group, Department of Immunology, Microbiology and Parasitology, Faculty of Science and Technology, University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Idoia Buldain
- Fungal and Bacterial Biomics Research Group, Department of Immunology, Microbiology and Parasitology, Faculty of Science and Technology, University of the Basque Country (UPV/EHU), Leioa, Spain
| | | | | | | | | | - Stephane Ranque
- Laboratoire de Parasitologie-Mycologie, AP-HM / CHU Timone, Marseille, France
| | - Vladimir Havlicek
- Institute of Microbiology, Academy of Sciences of the Czech Republic, Prague, Czech Republic
| | - Patrick Vandeputte
- Laboratoire de Parasitologie-Mycologie, CHU, Angers, France.,Host-Pathogen Interaction Study Group (EA 3142), UNIV Angers, UNIV Brest, Angers, France
| | - Yohann Le Govic
- Laboratoire de Parasitologie-Mycologie, CHU, Angers, France.,Host-Pathogen Interaction Study Group (EA 3142), UNIV Angers, UNIV Brest, Angers, France
| | - Jean-Philippe Bouchara
- Laboratoire de Parasitologie-Mycologie, CHU, Angers, France.,Host-Pathogen Interaction Study Group (EA 3142), UNIV Angers, UNIV Brest, Angers, France
| | - Sandrine Giraud
- Host-Pathogen Interaction Study Group (EA 3142), UNIV Angers, UNIV Brest, Angers, France
| | - Sharon Chen
- Centre for Infectious Diseases and Microbiology Laboratory Services, ICPMR, Westmead Hospital, The University of Sydney, New South Wales, Australia
| | - Johannes Rainer
- Institute of Microbiology, Leopold-Franzens University Innsbruck, Austria
| | - Ana Alastruey-Izquierdo
- Mycology Reference Laboratory, National Centre for Microbiology. Instituto de Salud Carlos III. Majadahonda, Madrid, Spain
| | | | | | - Javier Peman
- Microbiology Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Carsten Schwarz
- Cystic Fibrosis Centre Berlin/Charité-Universitätsmedizin Berlin, Germany
| | - Anne Bernhardt
- Mycotic and Parasitic Agents and Mycobacteria, Robert Koch Institute, Berlin, Germany
| | - Kathrin Tintelnot
- Mycotic and Parasitic Agents and Mycobacteria, Robert Koch Institute, Berlin, Germany
| | - Javier Capilla
- Mycology Unit, Medical School and IISPV, Universitat Rovira i Virgili, Reus, Spain
| | - Adela Martin-Vicente
- Mycology Unit, Medical School and IISPV, Universitat Rovira i Virgili, Reus, Spain.,Department of Clinical Pharmacy and Translational Science, University of Tennessee Health Science Center, Memphis, TN USA
| | - Jose Cano-Lira
- Mycology Unit, Medical School and IISPV, Universitat Rovira i Virgili, Reus, Spain
| | - Markus Nagl
- Division of Hygiene and Medical Microbiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Michaela Lackner
- Division of Hygiene and Medical Microbiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Laszlo Irinyi
- Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Westmead Clinical School, Sydney Medical School - Westmead Hospital, Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney, Westmead Institute for Medical Research, Sydney, New South Wales, Australia
| | - Wieland Meyer
- Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Westmead Clinical School, Sydney Medical School - Westmead Hospital, Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney, Westmead Institute for Medical Research, Sydney, New South Wales, Australia
| | - Sybren de Hoog
- Westerdijk Fungal Biodiversity Institute, Utrecht, The Netherlands
| | - Fernando L Hernando
- Fungal and Bacterial Biomics Research Group, Department of Immunology, Microbiology and Parasitology, Faculty of Science and Technology, University of the Basque Country (UPV/EHU), Leioa, Spain
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11
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Guadalajara MCV, Hernández González A, Carrasco García de León S, Rojo MG, Del Real Francia MÁ. Mycotic Cerebral Aneurysms Secondary to Scedosporium Prolificans Infection in a Patient with Multiple Sclerosis. J Clin Neurol 2018; 14:601-603. [PMID: 30284775 PMCID: PMC6172504 DOI: 10.3988/jcn.2018.14.4.601] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 08/06/2018] [Accepted: 08/06/2018] [Indexed: 11/17/2022] Open
Affiliation(s)
| | | | | | - Marcial García Rojo
- Department of Anatomical Pathology, University General Hospital, Ciudad Real, Spain
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12
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Doss M, Doss D. Skull base osteomyelitis secondary to Scedosporium apiospermum infection. Radiol Case Rep 2018; 13:759-763. [PMID: 29887928 PMCID: PMC5991900 DOI: 10.1016/j.radcr.2018.05.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 05/03/2018] [Accepted: 05/05/2018] [Indexed: 11/19/2022] Open
Abstract
Scedosporium apiospermum is a common environmental mold which is increasingly reported in the literature as a cause of infection, particularly in the immunocompromised patient population. We present a case of malignant otitis externa due to S apiospermum, complicated by spread of infection causing skull base osteomyelitis, internal carotid artery vasculitis and subsequent stroke. Despite the multiple complications encountered, prompt diagnosis and initiation of appropriate antifungal treatment resulted in patient survival. Multiple imaging modalities were used to aid the establishment of the diagnosis in this complex case and highlight the radiological findings associated with skull base osteomyelitis and its possible complications.
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Affiliation(s)
- Martin Doss
- Campbelltown Hospital, Therry Road, Campbelltown, Sydney, NSW 2560, Australia
- Corresponding author.
| | - David Doss
- Liverpool Hospital, Elizabeth Street, Liverpool, Sydney, NSW 2170, Australia
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13
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Dinh A, Demay O, Rottman M, Gaudot F, Bougnoux ME, Bouchand F, Coignard H, Rouzaud C, Davido B, Duran C, Nich C. Case of femoral pseudarthrosis due to Scedosporium apiospermum in an immunocompetent patient with successful conservative treatment and review of literature. Mycoses 2018; 61:400-409. [PMID: 29274090 DOI: 10.1111/myc.12739] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2017] [Revised: 12/11/2017] [Accepted: 12/16/2017] [Indexed: 11/28/2022]
Abstract
Scedosporium apiospermum is a ubiquitous filamentous fungus, commonly found in soil, sewage and polluted waters. It is rarely pathogenic but can cause a broad spectrum of clinical diseases, which can be localised or disseminate to distant organs. The disseminated form of the disease is mostly seen among immunocompromised patients. However, some rare cases of disseminated disease have been reported in immunocompetent individuals. Treatment of these infections is challenging because of their natural resistance to many antifungal agents. Here, we report the case of a 57-year-old immunocompetent patient diagnosed with femoral pseudarthrosis due to S. apiospermum, despite having no obvious clinical sign of infection. Previously, the patient had undergone four iterative femoral surgeries following a road traffic accident which occurred 20 years before. During its last surgery for pseudarthrosis, no clinical or biological signs of infection were present. Per operative samples tested positive for S. apiospermum. The patient was successfully treated with oral voriconazole during 6 months with an excellent tolerance. We also provide a review of literature on bone and joint infections due to Scedosporium spp. (S. apiospermum, Scedosporium boydii and Scedosporium aurantiacum), discussing the evolution of their management and outcome which seems to improve since the use of voriconazole.
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Affiliation(s)
- Aurélien Dinh
- Infectious Diseases Unit, Raymond Poincaré Teaching Hospital, AP-HP, Versailles Saint-Quentin University, Garches, France
| | - Olivier Demay
- Orthopaedic Surgery Department, Raymond Poincaré Teaching Hospital, AP-HP, Versailles Saint-Quentin University, Garches, France
| | - Martin Rottman
- Microbiology Laboratory, Raymond Poincaré Teaching Hospital, AP-HP, Versailles Saint-Quentin University, Garches, France
| | - Fabrice Gaudot
- Orthopaedic Surgery Department, Raymond Poincaré Teaching Hospital, AP-HP, Versailles Saint-Quentin University, Garches, France
| | | | - Frédérique Bouchand
- Pharmacy Department, Raymond Poincaré Teaching Hospital, AP-HP, Versailles Saint-Quentin University, Garches, France
| | - Hélène Coignard
- Infectious Diseases Department, Necker Teaching Hospital, AP-HP, Paris Descartes University, Paris, France
| | - Claire Rouzaud
- Infectious Diseases Department, Necker Teaching Hospital, AP-HP, Paris Descartes University, Paris, France
| | - Benjamin Davido
- Infectious Diseases Unit, Raymond Poincaré Teaching Hospital, AP-HP, Versailles Saint-Quentin University, Garches, France
| | - Clara Duran
- Infectious Diseases Unit, Raymond Poincaré Teaching Hospital, AP-HP, Versailles Saint-Quentin University, Garches, France
| | - Christophe Nich
- Orthopaedic Surgery Department, Raymond Poincaré Teaching Hospital, AP-HP, Versailles Saint-Quentin University, Garches, France
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14
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Ogawa Y, Sato M, Tashiro M, Miyazaki M, Nagata K, Takahashi N, Kasahara K, Izumikawa K, Yano H, Mikasa K. Rapid development of a mycotic aneurysm of the intracranial artery secondary to Scedosporium apiospermum sinusitis. Med Mycol Case Rep 2016; 14:30-32. [PMID: 28053848 PMCID: PMC5198637 DOI: 10.1016/j.mmcr.2016.11.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Revised: 11/23/2016] [Accepted: 11/24/2016] [Indexed: 11/29/2022] Open
Abstract
An 85-year-old man complained of a 2-month history of pain on the left side of his face. Brain computed tomography (CT) and magnetic resonance imaging/magnetic resonance angiography did not clearly show any intracranial abnormality and only showed fluid effusion in his left sphenoid sinus. Filamentous fungi were detected from the left sphenoid sinus specimen. The isolate was Scedosporium apiospermum. He was empirically treated with voriconazole, to which the isolate was susceptible. His consciousness decreased rapidly. Urgent 3D-CT angiography revealed an intracranial aneurysm near the left sphenoid sinus. Despite urgent coil embolization, the aneurysm ruptured, and he died.
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Affiliation(s)
- Yoshihiko Ogawa
- Center for Infectious Diseases, Nara Medical University, Shijo 840, Kashihasa, Nara, Japan
| | - Masatoshi Sato
- Department of Infectious Diseases, Nara City Hospital, Nara, Japan
| | - Masato Tashiro
- Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Masayuki Miyazaki
- Department of Neurology, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Kiyoshi Nagata
- Department of Neurosurgery, Nara City Hospital, Nara, Japan
| | | | - Kei Kasahara
- Center for Infectious Diseases, Nara Medical University, Shijo 840, Kashihasa, Nara, Japan
| | - Koichi Izumikawa
- Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Hisakazu Yano
- Department of Microbiology and Infectious Diseases, Nara Medical University, Nara, Japan
| | - Keiichi Mikasa
- Center for Infectious Diseases, Nara Medical University, Shijo 840, Kashihasa, Nara, Japan
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15
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Taj-Aldeen SJ, Rammaert B, Gamaletsou M, Sipsas NV, Zeller V, Roilides E, Kontoyiannis DP, Miller AO, Petraitis V, Walsh TJ, Lortholary O. Osteoarticular Infections Caused by Non-Aspergillus Filamentous Fungi in Adult and Pediatric Patients: A Systematic Review. Medicine (Baltimore) 2015; 94:e2078. [PMID: 26683917 PMCID: PMC5058889 DOI: 10.1097/md.0000000000002078] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Osteoarticular mycoses due to non-Aspergillus moulds are uncommon and challenging infections. A systematic literature review of non-Aspergillus osteoarticular mycoses was performed using PUBMED and EMBASE databases from 1970 to 2013. Among 145 patients were 111 adults (median age 48.5 [16-92 y]) and 34 pediatric patients (median age 7.5 [3-15 y]); 114 (79.7%) were male and 88 (61.9%) were immunocompromised. Osteomyelitis was due to direct inoculation in 54.5%. Trauma and puncture wounds were more frequent in children (73.5% vs 43.5%; P = 0.001). Prior surgery was more frequent in adults (27.7% vs 5.9%; P = 0.025). Vertebral (23.2%) and craniofacial osteomyelitis (13.1%) with neurological deficits predominated in adults. Lower limb osteomyelitis (47.7%) and knee arthritis (67.8%) were predominantly seen in children. Hyalohyphomycosis represented 64.8% of documented infections with Scedosporium apiospermum (33.1%) and Lomentospora prolificans (15.8%) as the most common causes. Combined antifungal therapy and surgery was used in 69% of cases with overall response in 85.8%. Median duration of therapy was 115 days (range 5-730). When voriconazole was used as single agent for treatment of hyalohyphomycosis and phaeohyphomycosis, an overall response rate was achieved in 94.1% of cases. Non-Aspergillus osteoarticular mycoses occur most frequently in children after injury and in adults after surgery. Accurate early diagnosis and long-course therapy (median 6 mo) with a combined medical-surgical approach may result in favorable outcome.
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Affiliation(s)
- Saad J Taj-Aldeen
- From the Mycology Unit, Microbiology Division, Department of Laboratory Medicine and Pathology, Hamad Medical Corporation, Doha, Qatar (SJT-A); Center for Osteoarticular Mycoses, Hospital for Special Surgery (SJT-A, BR, MG, NVS, ER, AOM, VP, TJW, OL); International Osteoarticular Mycoses Study Consortium, NY (SJT-A, BR, MG, NVS, ER, AOM, VP, TJW, OL); Weill Cornell Medical College, Doha, Qatar (SJT-A); Université Paris-Descartes, Sorbonne Paris Cité, APHP, Service des Maladies Infectieuses et Tropicales, Hôpital Necker-Enfants Malades, Centre d'Infectiologie Necker-Pasteur, Institut Imagine (BR, OL); Institut Pasteur, Mycology Molecular Unit, Paris, France (BR, OL); Transplantation-Oncology Infectious Diseases Program, Department of Medicine, Weill Cornell Medical Center of Cornell University (MG, AOM, VP, TJW); Pediatrics, and Microbiology & Immunology, Weill Cornell Medical Center of Cornell University, New York, NY (MG, NVS, TJW); National and Kapodistrian University of Athens, Athens, Greece (MG, NVS); Osteoarticular Reference Center, Groupe Hospitalier Diaconesses-Croix Saint-Simon, Paris, France (VZ); Infectious Diseases Unit, Department of Pediatrics, Faculty of Medicine, Aristotle University, School of Health Sciences, and Hippokration Hospital, Thessaloniki, Greece (ER); and MD Anderson Cancer Center, Houston, TX (DPK)
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16
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Blasco-Lucas A, Reyes-Juárez JL, Nazarena Pizzi M, Permanyer E, Evangelista A, Galiñanes M. Aortic Arch Mycotic Aneurysm Due to Scedosporium Apiospermum Reconstructed With Homografts. Ann Thorac Surg 2015; 99:2218-20. [PMID: 26046885 DOI: 10.1016/j.athoracsur.2014.08.067] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Revised: 08/08/2014] [Accepted: 08/29/2014] [Indexed: 10/23/2022]
Abstract
A 39-year-old female, active parenteral drug user was diagnosed of spondylodiscitis. A computed tomography (CT) scan showed an extensive aortic arch aneurysm. A positron emission tomography (PET)-CT scan, showing significant aortic wall uptake of the tracer through the whole aortic arch and the D8-D9 intervertebral disc, allowed us to suspect an aortitis despite negative blood cultures. The aneurysm was resected and reconstructed with 2 aortic homografts. Cultures of specimens from the aortic wall were positive to the fungi Scedosporium apiospermum. A new PET-CT scan 4 months after surgery showed absence of tracer uptake both at the homografts site and intervertebral disc.
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Affiliation(s)
- Arnau Blasco-Lucas
- Department of Cardiac Surgery, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | | | | | - Eduard Permanyer
- Department of Cardiac Surgery, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Arturo Evangelista
- Department of Cardiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Manuel Galiñanes
- Department of Cardiac Surgery, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
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17
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Case Report of Vertebral Osteomyelitis and Mycotic Abdominal Aortic Aneurysm Caused by Scedosporium apiospermum in a Lung Transplant Patient With Cystic Fibrosis. Transplant Proc 2015; 47:204-9. [DOI: 10.1016/j.transproceed.2014.07.072] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Accepted: 07/15/2014] [Indexed: 11/17/2022]
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18
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Watanabe I, Nakayama T, Yamada E, Tsukino M, Hayashi E. Invasive aspergillosis in the aortic arch with infectious Aspergillus lesions in pulmonary bullae. Med Mycol Case Rep 2014; 7:15-9. [PMID: 27330942 PMCID: PMC4909881 DOI: 10.1016/j.mmcr.2014.12.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Revised: 11/23/2014] [Accepted: 12/19/2014] [Indexed: 11/17/2022] Open
Abstract
A patient with pulmonary bullae died of massive hemoptysis. At autopsy a hole was observed in the aortic wall. A microscopic examination indicated small Aspergillus lesions in pulmonary bullae and extensive necrotic lesions with Aspergillus hyphae in the media of the thoracic aorta. These findings led to a diagnosis of invasive aspergillosis in the aortic arch. This is a rare case in which Aspergillus invaded the aorta in a patient without hematologic neoplasms or neutropenia.
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Affiliation(s)
- Isao Watanabe
- Department of Respiratory Diseases, Hikone Municipal Hospital, 1882 Hassaka-cho, Hikone, Shiga, Hikone 522-8539, Japan
| | - Takahisa Nakayama
- Laboratory of Diagnostic Pathology, Hikone Municipal Hospital, 1882 Hassaka-cho, Hikone, Shiga, Hikone 522-8539, Japan
| | - Eiji Yamada
- Laboratory of Diagnostic Pathology, Hikone Municipal Hospital, 1882 Hassaka-cho, Hikone, Shiga, Hikone 522-8539, Japan
| | - Mitsuhiro Tsukino
- Department of Respiratory Diseases, Hikone Municipal Hospital, 1882 Hassaka-cho, Hikone, Shiga, Hikone 522-8539, Japan
| | - Eiichi Hayashi
- Department of Respiratory Diseases, Hikone Municipal Hospital, 1882 Hassaka-cho, Hikone, Shiga, Hikone 522-8539, Japan
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19
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Algarni A, Alawfi A, Aidaroos AYA, Donesa J, Parvez S. Wound Infection Caused by Pseudallescheria boydi with Black Discharge: A Case Report. JOURNAL OF MEDICAL SCIENCES 2014. [DOI: 10.3923/jms.2014.201.205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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20
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Uno K, Kasahara K, Kutsuna S, Katanami Y, Yamamoto Y, Maeda K, Konishi M, Ogawa T, Yoneda T, Yoshida K, Kimura H, Mikasa K. Infective endocarditis and meningitis due to Scedosporium prolificans in a renal transplant recipient. J Infect Chemother 2014; 20:131-3. [DOI: 10.1016/j.jiac.2013.09.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2013] [Revised: 09/08/2013] [Accepted: 09/12/2013] [Indexed: 10/25/2022]
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21
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Sayah DM, Schwartz BS, Kukreja J, Singer JP, Golden JA, Leard LE. Scedosporium prolificans pericarditis and mycotic aortic aneurysm in a lung transplant recipient receiving voriconazole prophylaxis. Transpl Infect Dis 2013; 15:E70-4. [PMID: 23387799 DOI: 10.1111/tid.12056] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2012] [Revised: 10/13/2012] [Accepted: 11/23/2012] [Indexed: 11/28/2022]
Abstract
Despite the adoption of antifungal prophylaxis, fungal infections remain a significant concern in lung transplant recipients. Indeed, some concern exists that such prophylaxis may increase the risk of infection with drug-resistant fungal organisms. Here, we describe a case of disseminated Scedosporium prolificans infection, presenting as pericarditis, which developed in a lung transplant patient receiving prophylactic voriconazole for 8 months. The epidemiology and clinical presentation of S. prolificans infections are reviewed, and controversies surrounding antifungal prophylaxis and the development of resistant infections are discussed.
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Affiliation(s)
- D M Sayah
- Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, Department of Medicine, University of California, San Francisco, California, USA.
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22
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Malinowski MJ, Halandras P. Arterial reconstruction for atypical mycotic aneurysms. Vasc Endovascular Surg 2012; 47:45-7. [PMID: 23047819 DOI: 10.1177/1538574412462636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Our case involves a 67-year-old man with a post lung transplantation status for idiopathic pulmonary fibrosis, who was initially referred to our institution for treatment of left hip septic arthritis due to Pseudallescheria boydii infection. One month following total hip arthroplasty, he noticed left upper thigh swelling with duplex imaging consistent with a 7-cm mid-superficial femoral artery aneurysm with popliteal vein compression and associated deep venous thrombosis. During operative resection, exploration of his contralateral saphenous vein showed inadequate conduit for use. Therefore, we proceeded with proximal and distal clamp control with intraoperative arterial shunting followed by cryoarterial reconstruction after complete aneurysm sac resection and debridement. Intraoperative arterial wall cultures remained negative for bacterial pathogens; however, final operative fungal cultures once again grew Pseudallescheria boydii. Our case highlights the complexity of adequate source control with effective arterial reconstruction in these immunosuppressed patient populations, particularly with fungal organisms that historically have poor therapeutic response to medical therapy alone.
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23
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Ezzatzadegan S, Chen S, Chapman JR. Invasive fungal infections after renal transplantation. Int J Organ Transplant Med 2012; 3:18-25. [PMID: 25013619 PMCID: PMC4089273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Invasive fungal infection (IFI) is a leading cause of infection-related mortality among kidney allograft recipients. OBJECTIVE To estimate the incidence and etiology of systemic fungal infection in renal allograft recipients in Sydney transplant facility. METHODS 471 kidney recipients, transplanted between 2000 and 2010 at the Westmead Hospital renal transplantation center, Sydney, Australia, were retrospectively surveyed. RESULTS IFI developed in 10 (2.1%) of 471 patients. With a mean±SD new kidney transplants per year of 42.9±13, the mean±SD incidence of IFI was 0.9±0.6 for each year of transplantation. 4 patients had received kidneys from living donors and 7 from cadavers with a mean±SD age of 50.5±14 years. The mean time to IFI was 33 months after transplantation with majority within the first 2 years. Cryptococcus neoformans was responsible for 50% of episodes (n=5) followed by Aspergillus fumigatus (n=3), and Pseudallescheria boydii (n=3); there was a single case of mucurmycosis. Lungs (n=5) followed by meninges (n=4) and skin (n=3) were the most commonly involved sites. CONCLUSION IFI remains a major concern in renal transplantation. A high index of suspicion is required for early diagnosis and treatment to reduce the mortality. In this regard, appropriate diagnostic tests are necessary, particularly for C. neoformans.
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Affiliation(s)
- S. Ezzatzadegan
- Shiraz Nephrology Urology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran,,Correspondence: Shahrokh Ezzatzadegan, MD, Assistant Professor of Internal Medicine, Department of Internal Medicine, Namazee Hospital, Shiraz, Iran.
Phone: +98-917-313-8034
Fax: +98-711-647-4316
E-mail:
| | - S. Chen
- Center for Infectious Diseases and Microbiology, Westmead Hospital , Westmead, Sydney , NSW, Australia,
| | - J. R. Chapman
- Center for Transplant and Renal Research, University of Sydney, Westmead Hospital, Sydney , NSW, Australia
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