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Persistent subcutaneous Scedosporium apiospermum infection
Patrizia Posteraro1, Camille Frances, Biagio Didona
1Department of Clinical and Molecular Pathology Instituto Dermopatico d'ell'Immacolata, IDI-IRCCS, Via dei Monti di Creta, 104, 00167 Rome, Italy.
European Journal of Dermatology : EJD
|January 15, 2004
Summary
A heart transplant patient experienced a persistent Scedosporium apiospermum subcutaneous infection. Surgical intervention alongside antifungal medication was required for two years, highlighting the limitations of medical treatment alone for this rare fungal infection.
Area of Science:
- Mycology
- Infectious Diseases
- Transplant Surgery
Background:
- Heart transplant recipients are immunocompromised, increasing susceptibility to opportunistic infections.
- Scedosporium apiospermum is an emerging fungal pathogen causing infections in immunocompromised individuals.
- Subcutaneous mycoses, like mycetoma, are fungal infections of the skin and underlying tissues.
Observation:
- A 52-year-old male heart transplant recipient presented with a localized subcutaneous infection.
- The infection, caused by Scedosporium apiospermum, manifested as multiple nodules on the right hand.
- Unlike typical mycetoma, this infection lacked characteristic granules.
Findings:
- Surgical removal of nodules was performed.
- The patient received oral itraconazole, a standard antifungal medication.
- Despite treatment, the infection persisted for two years, necessitating multiple surgical interventions.
Implications:
- This case underscores the challenges in treating Scedosporium apiospermum infections in immunocompromised patients.
- Aggressive surgical management may be crucial in conjunction with antifungal therapy.
- Medical treatment alone may be insufficient for eradicating localized subcutaneous Scedosporium infections, particularly in transplant recipients.