Pulmonary &lt;i&gt;Scedosporium apiospermum&lt;/i&gt; Infection with Pulmonary Tumorlet in an Immunocompetent Patient

Motokawa, Nana; Miyazaki, Taiga; Hara, Atsuko; Fukuda, Yuichi; Morino, Saori; Nakamura, Hiroaki; Iwasaki, Keisuke; Soda, Hiroshi; Izumikawa, Koichi; Yanagihara, Katsunori; Ohno, Hideaki; Miyazaki, Yoshitsugu; Kohno, Shigeru; Mukae, Hiroshi

doi:10.2169/internalmedicine.1239-18

Cited by 6 publications

(9 citation statements)

References 24 publications

(22 reference statements)

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“…Antifungal minimum inhibitory concentrations were measured in 6 reports. [20,22,24,27,30,33] Four cases reported drug-related side-effect attributed to miconazole and voriconazole, leading to the discontinuation of treatment. [8,22,34,35]…”

Section: Resultsmentioning

confidence: 99%

“…Nevertheless, it is worth to notice that a 5-year follow-up was conducted in 2 cases in our study. [27,29] One case reported a 73-year-old woman who developed S apiospermum lung infection and a pulmonary tumorlet. [29] The other case reported a 40-year-old woman who had right lower cystic bronchiectasis and S apiospermum colonization.…”

Section: Discussionmentioning

confidence: 99%

“…[29] The other case reported a 40-year-old woman who had right lower cystic bronchiectasis and S apiospermum colonization. [27] Lobectomy was performed without any antifungal treatment in both cases, and no recurrence occurred during the 5-year follow-up period.…”

Section: Discussionmentioning

confidence: 99%

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Scedosporium spp lung infection in immunocompetent patients

2019

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Scedosporium spp lung infection in immunocompetent patients

2019

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“…S. apiospermum infection is di cult to treat as it has been reported to be resistant to many antifungal agents, such as uconazole, ketoconazole, ucytosine, terbina ne, itraconazole, and liposomal amphotericin B. Nevertheless, it is susceptible to voriconazole, and a few studies have reported its e cacy in the treatment of S. apiospermum infection [5,12,13,15]. According to the literature, surgical resection is an effective treatment for localized lesions, and even in immunocompetent individuals, the infection usually necessitates complete surgical resection [1].…”

Section: Literature Reviewmentioning

confidence: 99%

“…Based on the PET-CT report, it is suggested that the local metabolic activity of the upper lobe of the right lung was increased (SUVmax =2.8), and peripheral gonadal carcinoma was suspected; 2. after antifungal treatment, the foci were not signi cantly absorbed, and the possibility of pulmonary fungal infection complicated with lung cancer could not be excluded. This surgery aimed to remove the foci and actively resect the pulmonary tumor simultaneously based on a reported case of pulmonary S. apiospermum infection with pulmonary tumorlets in an immunocompetent patient [15]. The patient was followed up for 10 months after surgery, and the therapeutic effect was effective.…”

Section: Literature Reviewmentioning

confidence: 99%

Diagnosis of Pulmonary Scedosporium apiospermum Infection from Bronchoalveolar Lavage Fluid by Metagenomic Next-Generation Sequencing in an Immunocompetent Female Patient with Normal Lung Structure: A Case Report and Literature Review

Han

Liu

et al. 2023

Preprint

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Background: Scedosporium apiospermum (S.apiospermum) belongs to the asexual form of Pseudallescheria boydiiand is widely distributed in various environments. S. apiospermumis the most common cause of pulmonary infection; however, invasive diseases are usually limited to patients with immunodeficiency. Case presentation: A 54-year-old Chinese non-smoker female patient with normal lung structure and function was diagnosed with pulmonary S. apiospermum infection by metagenomic next-generation sequencing (mNGS) of bronchoalveolar lavage fluid (BALF). The patient was admitted to the hospital after experiencing intermittent right chest pain for 8 months. Chest computed tomography revealed a thick-walled cavity in the upper lobe of the right lung with mild soft tissue enhancement. S. apiospermum was observed by the mNGS of BALF, sequence number 283. Following treatment with voriconazole (300 mg q12h d1; 200 mg q12h d2-d20), there was no improvement in chest imaging, and a thoracoscopic right upper lobectomy was performed. Postoperative pathological results observed silver staining and PAS-positive oval spores in the alveolar septum, bronchiolar wall, and alveolar cavity, and fungal infection was considered. The patient’s symptoms improved; the patient continued voriconazole for 2 months after surgery. No signs of radiological progression or recurrence were observed at the 10-month postoperative follow-up. Conclusion: This case report indicates that S. apiospermum infection can occur in immunocompetent individuals and that the mNGS of BALF can assist in its diagnosis and treatment. Additionally, the combined therapy of antifungal drugs and surgery exhibits a potent effect on the disease.

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Scedosporiosis and lomentosporiosis: modern perspectives on these difficult-to-treat rare mold infections

Neoh,

Chen,

Lanternier

et al. 2024

Clin Microbiol Rev

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SUMMARY Although Scedosporium species and Lomentospora prolificans are uncommon causes of invasive fungal diseases (IFDs), these infections are associated with high mortality and are costly to treat with a limited armamentarium of antifungal drugs. In light of recent advances, including in the area of new antifungals, the present review provides a timely and updated overview of these IFDs, with a focus on the taxonomy, clinical epidemiology, pathogenesis and host immune response, disease manifestations, diagnosis, antifungal susceptibility, and treatment. An expansion of hosts at risk for these difficult-to-treat infections has emerged over the last two decades given the increased use of, and broader population treated with, immunomodulatory and targeted molecular agents as well as wider adoption of antifungal prophylaxis. Clinical presentations differ not only between genera but also across the different Scedosporium species. L. prolificans is intrinsically resistant to most currently available antifungal agents, and the prognosis of immunocompromised patients with lomentosporiosis is poor. Development of, and improved access to, diagnostic modalities for early detection of these rare mold infections is paramount for timely targeted antifungal therapy and surgery if indicated. New antifungal agents (e.g., olorofim, fosmanogepix) with novel mechanisms of action and less cross-resistance to existing classes, availability of formulations for oral administration, and fewer drug-drug interactions are now in late-stage clinical trials, and soon, could extend options to treat scedosporiosis/lomentosporiosis. Much work remains to increase our understanding of these infections, especially in the pediatric setting. Knowledge gaps for future research are highlighted in the review.

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Pulmonary <i>Scedosporium apiospermum</i> Infection with Pulmonary Tumorlet in an Immunocompetent Patient

Cited by 6 publications

References 24 publications

Scedosporium spp lung infection in immunocompetent patients

Scedosporium spp lung infection in immunocompetent patients

Diagnosis of Pulmonary Scedosporium apiospermum Infection from Bronchoalveolar Lavage Fluid by Metagenomic Next-Generation Sequencing in an Immunocompetent Female Patient with Normal Lung Structure: A Case Report and Literature Review

Scedosporiosis and lomentosporiosis: modern perspectives on these difficult-to-treat rare mold infections

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