Scedosporium apiospermumskeletal infection in an immunocompetent child

Abstract

This is a case of Scedosporium apiospermum skeletal infection in a 10-year-old immunocompetent girl whose chief complaint was left knee swelling and pain. The child had a history of a bicycle accident two months before with a resultant deep penetrating trauma. Systematic administration of broad-spectrum antibiotics for 10 days was used, with no clinical improvement. Magnetic Resonance Imaging and arthrotomy of the affected joint revealed findings suggestive of osteomyelitis. Empirical intravenous antimicrobial therapy was instituted for a total of two months but one month after completion of antibacterial therapy the child returned to the hospital because of persistent knee swelling and pain. Following a new arthrotomy, Scedosporium apiospermum was isolated. The patient was cured with intravenous administration of voriconazole without any side effects and has no evidence of relapse after four years of follow-up.

N -Chlorotaurine Exhibits Fungicidal Activity against Therapy-Refractory Scedosporium Species and Lomentospora prolificans

“…The immune status of the patient is the key to the severity and degree of dissemination of scedosporiosis (2,3), ranging from mild lymphocutaneous infections, osteomyelitis (4,5), otitis, eye infection, endophthalmitis (6), and brain abscess (7) to life-threatening disseminated infections involving the central nervous system (CNS). Invasive pulmonary scedosporiosis typically occurs in predisposed patients (e.g., solid organ transplant patients) and on occasion in healthy humans (e.g., heavy smokers) (8).…”

Severe prosthetic joint infection in an immunocompetent male patient due to a therapy refractory Pseudallescheria apiosperma

“…Scedosporium osteomyelitis can emerge if contaminated material is deeply inoculated, 30–33 either by trauma or during surgery. The severity, aetiopathology, and the potency of dissemination are dependent individually on the immune status of the patient 18,30,31,34,35 . Since our patient was neither immunosuppressed nor suffered from other severe/predisposing, underlying diseases, the fast progress of infection is exceptional.…”

Post‐traumatic Pseudallescheria apiosperma osteomyelitis: positive outcome of a young immunocompetent male patient due to surgical intervention and voriconazole therapy

“…Osteomyelitis by Pseudallescheria/Scedosporium is characterised by slow progression, often with a delay of months between probable inoculation, first symptoms and final isolation of the fungus from clinical samples 8,19 . The most frequently affected sites are the lower limbs, especially the knee joints leading to arthritis 6,8,20,21 . The infection nearly exclusively results from trauma involving foreign bodies or soil 6,19,21 .…”

“…Stipeli et al. [8] described a post‐traumatic infection by P. apiospermum in a 10‐year‐old immunocompetent girl. She was cured with long‐term intravenous voriconazole administration.…”