Scedosporium apiospermum: a fungal pathogen causing pneumonia in a patient with cystic fibrosis. Issue 3 (June 2015)

• Record Type: Journal Article
• Authors: Schwarz, Carsten; Thronicke, Anja; Staab, Doris; Tintelnot, Kathrin
• Is Part Of: JMM case reports. Volume 2:Issue 3(2015)
• Publication Date: 2015-06
• Subjects: Scedosporium apiospermum -- Cystic fibrosis -- pneumonia; Medical microbiology -- Periodicals; 616.9041
• DOI: 10.1099/jmmcr.0.000061
• Languages: English
• ISSNs: 2053-3721

Abstract

Abstract : Introduction: Scedosporium apiospermum is a slow-growing pathogenic fungus that can cause pneumonia. Diagnosis of this rare filamentous fungus is challenging. To the best of our knowledge, this is the first case describing an acute pulmonary infection caused by this fungal pathogen in a patient with cystic fibrosis (CF). Case presentation: A 35-year-old female with CF, with a 1-month history of irritating cough, increased sputum production and dyspnoea, was admitted to hospital. A chest computed tomography scan revealed new bilateral infiltrations, mediastinal lymphadenopathy and bronchiectasis. Pseudomonas aeruginosa and S. apiospermum were detected in the bronchoalveolar lavage. The patient's clinical status was not improved by standard antibiotic therapy. Antifungal systemic therapy consisting of systemic caspofungin and oral posaconazole against the highly suspected scedosporiosis was initiated, but the clinical outcome was not significantly improved. Antibodies against the S. apiospermum complex were present in the patient's serum. Only after the addition of 50 mg once a day of inhaled liposomal amphotericin B the patient was successfully treated. Conclusion: The patient was cured by a combined therapy of two systemic antimycotic drugs and one local antimycotic drug.