Infections Caused byScedosporiumspp

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Abstract
SUMMARY: Scedosporiumspp. are increasingly recognized as causes of resistant life-threatening infections in immunocompromised patients.Scedosporiumspp. also cause a wide spectrum of conditions, including mycetoma, saprobic involvement and colonization of the airways, sinopulmonary infections, extrapulmonary localized infections, and disseminated infections. Invasive scedosporium infections are also associated with central nervous infection following near-drowning accidents. The most common sites of infection are the lungs, sinuses, bones, joints, eyes, and brain.Scedosporium apiospermumandScedosporium prolificansare the two principal medically important species of this genus.Pseudallescheria boydii, the teleomorph ofS. apiospermum, is recognized by the presence of cleistothecia. Recent advances in molecular taxonomy have advanced the understanding of the genusScedosporiumand have demonstrated a wider range of species than heretofore recognized. Studies of the pathogenesis of and immune response toScedosporiumspp. underscore the importance of innate host defenses in protection against these organisms. Microbiological diagnosis ofScedosporiumspp. currently depends upon culture and morphological characterization. Molecular tools for clinical microbiological detection ofScedosporiumspp. are currently investigational. Infections caused byS. apiospermumandP. boydiiin patients and animals may respond to antifungal triazoles. By comparison, infections caused byS. prolificansseldom respond to medical therapy alone. Surgery and reversal of immunosuppression may be the only effective therapeutic options for infections caused byS. prolificans.