Scedosporium and Lomentospora infections in lung transplant recipients

Rammaert, Blandine; Neoh, Zoe C.F.; Chen, Sharon C‐A; Kong, David Chee Ming; Slavin, Monica

doi:10.1007/s12281-021-00416-8

Cited by 1 publication

(1 citation statement)

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“…Interestingly, organ involvement outside the CNS and lung was reported only in disseminated L prolificans infections. Disseminated scedosporiosis has been described [ 10 , 25 ], but our study observed more localized and indolent skin/soft tissue infections with Scedosporium spp. While distinct clinical presentations between S apiospermum and Scedosporium boydii were reported in a large French observational study [ 12 ], we are unable to confirm this as the different species within the S apiospermum complex were not further differentiated given the retrospective nature of our study.…”

Section: Discussioncontrasting

confidence: 52%

InvasiveScedosporiumandLomentospora prolificansInfections in Australia: A Multicenter Retrospective Cohort Study

Neoh

Chen

Crowe

et al. 2023

Open Forum Infectious Diseases

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Background Management of Scedosporium/Lomentospora prolificans infections remain challenging. We described predisposing factors, clinical manifestations and outcomes of these rare mould infections, including predictors of early (1-month) and late (18-month) all-cause mortality and treatment failure. Methods We conducted a retrospective Australian-based observational study of proven/probable Scedosporium/Lomentospora prolificans infections from 2005 to 2021. Data on patient co-morbidities, predisposing factors, clinical manifestations, treatment and outcomes up to 18 months were collected. Treatment responses and death causality were adjudicated. Subgroup analyses, multivariable Cox and logistic regressions were performed. Results Of 61 infection episodes, 37 (60.7%) were attributable to Lomentospora prolificans. Forty-five (73.8%) were proven invasive fungal infections (IFD) and 29/61 (47.5%) were disseminated. Prolonged neutropenia and receipt of immunosuppressant agents were documented in 27/61 (44.3%) and 49/61 (80.3%) episodes, respectively. Voriconazole/terbinafine were administered in 30/31 (96.8%) Lomentospora prolificans infections and voriconazole alone was prescribed for 15/24 (62.5%) Scedosporium spp. infections. Adjunctive surgery was performed in 27/61 (44.3%) episodes. Median time to death post-IFD diagnosis was 9.0 days, and only 23/61 (37.7%) attained treatment success at 18 months. Those who survived beyond 28 days of antifungal therapy were less immunosuppressed with fewer disseminated infections (both p < 0.001). Disseminated infection and haematopoietic stem-cell transplant were associated with increased early and late mortality rates. Adjunctive surgery was associated with lower early and late mortality rates by 84.0% and 72.0%, respectively, and decreased odds of 1-month treatment failure by 87.0%. Conclusions Outcomes associated with Scedosporium/Lomentospora prolificans infections is poor, particularly with Lomentospora prolificans infections or in the highly immunosuppressed population.

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Section: Discussioncontrasting

confidence: 52%