Antifungal therapy and surgical drainage for the treatment of a cerebral abscess caused by Scedosporium apiospermum in a renal transplant patient - a case report

Abstract

Abstractthe asexual form of , is a Scedosporium apiospermum, Pseudallescheria boydii filamentous, opportunistic fungus which can be found in environmental sources all over the world. It is a human pathogen mostly associated with lung, bone and joint infections and less frequently with infections of the central nervous system (CNS). The latter is generally related to the patient's immune state, and occurs most frequently in immunocompromised patients. We present the case of a 64-year-old male patient with a background of chronic kidney failure secondary to nephroangiosclerosis and a renal transplantation who presented with left-sided hemiplegia and dysarthria. A brain MRI revealed a hyperintense lesion with ring enhancement at the right paramedian posterior frontal subcortical area with an associated vasogenic edema. A stereotactic biopsy of the lesion revealed the presence of . The patient received a S. apiospermum combined therapy of voriconazole and terbinafine with surgical drainage, which led to temporarily clinical and radiological improvement.