Post COVID-19 acute invasive fungal rhinosinusitis caused by Scedosporium apiospermum: a covert pathogen

Abstract

<p class="abstract">Immune dysregulation caused by COVID-19 and the presence of risk factors such as diabetes, steroid therapy and immune-modulatory drugs significantly increase the risk of secondary invasive fungal infections. <em>Scedosporium apiospermum </em>is an emerging pathogen and is rarely reported as a cause of fungal rhinosinusitis. This was a previously unreported case of post COVID-19 acute invasive fungal rhinosinusitis caused by <em>S. apiospermum</em> with rare complications of cranial nerve palsies and ruptured mycotic intracranial aneurysm.</p>

Time versus tissue: Timely identification of Scedosporium Rhinosinusitis in a post-COVID-19 case by MALDI-TOF MS leading to successful management

“…This will be the second case report of Scedosporium apiospermum infection in a post-COVID-19 patient and the first case has been reported by Singla et al. 3 Treatment of Scedosporium is challenging because of their resistance to various antifungals. In a study done in China, it was susceptible to the azole group of drugs.…”

“…Agricultural areas, as well as playgrounds and soils in urban surroundings, are found to be densely colonized with Scedosporium species. 6 , 3 …”

Scedosporium boydii disseminated infection complicating severe SARS-CoV2 infection in an immunocompetent patient: a case report

“…(10,11) Scedosporium spp infectionsare unusual in immunocompetent individuals, and are usually associated with histories of near drowning. (3) The incidence of IFIs in critically-ill COVID-19 patients has been calculated to be 10.7% (3.4% for invasive candida infections and 7.9% for aspergillus), although an incidence of up to 11% for COVID-19-associated invasive mold infection (CAIMI) has been reported for this patient population (12)(13). It is worthy to note that although CAIMI has been reported predominantly in immunocompetent patients, up to 94% of these patients receive treatment with corticosteroids and up to 19% anti IL-6 receptor antibodies.…”

“…It is worthy to note that although CAIMI has been reported predominantly in immunocompetent patients, up to 94% of these patients receive treatment with corticosteroids and up to 19% anti IL-6 receptor antibodies. (13) The incidence of IFIs due to Scedosporium spp. in patients COVID-19 has only been mentioned in a case series, representing one of 16 patients with CAIMI, for an overall incidence of 0.7%.…”

“…have been reported in COVID-19 patients: none of these infections were disseminated (3 rhinosinal, 2 pulmonary and 2 lymphocutaeous infections), 5 of 7 (72%) presented in patients with diabetes, and only 1 of 7 (14%) had a reported fatal outcome; 4 of the 7 (57%) infections were due to Scedosporium apiospermum. (12)(13)(14)(15)(16)(17)(18)28) We report the rst case of a disseminated infection due to Scedosporium boydii in a critically-ill immunocompetent patient with COVID-19.…”