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Novel Presentation of Disseminated Scedosporium apiospermum in a Patient With Cystic Fibrosis: A Case Report and Review

Bhatia, Ramona MD; Galvin, Shannon MD

Infectious Diseases in Clinical Practice: July 2014 - Volume 22 - Issue 4 - p 198–203
doi: 10.1097/IPC.0000000000000127
Review Articles

Scedosporium species are ubiquitous opportunists capable of a wide spectrum of disease. In patients with cystic fibrosis (CF), colonization and, rarely, infection have been reported. We discuss a novel case of disseminated Scedosporium apiospermum in a CF patient presenting as multifocal osteomyelitis of the thoracic spine and left hand that was successfully treated with long-term voriconazole who was successfully treated with long-term voriconazole. We review the epidemiology, microbiology, diagnosis, treatment, and prognosis of scedosporiosis focusing on the CF and lung transplant populations. Tissue diagnosis with molecular techniques and drug sensitivity testing should be used in cases of suspected scedosporiosis due to high frequency of drug resistance. Timely initiation of and prolonged therapy with voriconazole are associated with improved clinical and radiographic outcome. Pre–lung transplant colonization with Scedosporium predisposes to disseminated infection with high morbidity and mortality in the posttransplant period. Optimal peri-transplant management of the CF patient with pre-transplant Scedosporium colonization or infection remains unknown and should be prioritized in research agendas.

From the Division of Infectious Diseases, Department of Medicine, Northwestern University, Chicago, IL.

Correspondence to: Ramona Bhatia, MD, Division of Infectious Diseases, Department of Medicine, Northwestern University, 645 N Michigan Ave, Suite 1058, Chicago, IL 60611. E-mail:

The authors have no funding or conflicts of interest to disclose.

© 2014 by Lippincott Williams & Wilkins.