A Case of Invasive Fungal Infection Due to Scedosporium apiospermum in a Patient with Psoriasis

Abstract

Scedosporium apiospermum ( S. apiospermum ) is typically reported to be involved in superficial and subcutaneous fungal infections but overlooked in invasive infections, which is associated with a high mortality rate. It poses a diagnostic challenge due to its confusable characteristics to other hyaline hyphomycetes. Here, we reported a psoriasis patient with an invasive S. apiospermum infection. The patient presents an abscess at the intermuscular space of the left hip and an increased C-reactive protein level. Pus culture showed white-greyish, cottonlike colonies with aerial mycelium and terminal oval conidia, suggesting S. apiospermum . This rare fungus was rapidly confirmed by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry and RNA sequencing. The patient was successfully treated with voriconazole with no recurrence of the abscesses despite delayed treatment. This is the first such case infection report from China that described an unusual case of intermuscular space abscesses due to S. apiospermum . This report highlights the possibility of fungal infections in deeper tissue, as well as the necessity of thorough evaluation and microbiological diagnosis for invasive infections, particularly in immunocompromised patients.

A Lateral-Flow Device for the Rapid Detection of Scedosporium Species

“…Scedosporium species are human pathogenic moulds. They are the agents of eumycetoma [1][2][3][4][5], a chronic deep fungal infection of the skin and subcutaneous tissues, and are responsible for a broad spectrum of localised and life-threatening disseminated infections in immunocompetent and immunocompromised individuals [6][7][8][9][10] affecting numerous organs of the body (Figure 1A), including the bones and joints [11][12][13], the central nervous system [14][15][16][17], the eyes [18][19][20][21][22][23][24], the lungs [14,[25][26][27][28][29][30][31][32][33], the sinuses [34][35][36], and other body sites [37][38][39] of cystic fibrosis patients [8,28,[40][41][42], haematopoietic stem cell and solid organ transplant recipients…”