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Clinical characteristics and epidemiology of pulmonary pseudallescheriasis

Ayse Serda Kantarcioglu1, Gerritis Sybren de Hoog, Josep Guarro

  • 1Department of Microbiology and Clinical Microbiology, Cerrahpasa Medical Faculty, 34303 Cerrahpasa, Istanbul, Turkey. s.kantarcioglu@superonline.com

Revista Iberoamericana De Micologia
|October 4, 2011
PubMed
Abstract

Insights

Pseudallescheria and Scedosporium fungi cause serious lung infections, ranging from colonization to invasive pneumonia. Invasive infections have higher mortality, particularly in immunocompromised individuals.

Area of Science:

  • Medical Mycology
  • Infectious Diseases
  • Pulmonology

Background:

  • Pseudallescheria (anamorph Scedosporium) species are increasingly recognized as significant human pathogens.
  • Pulmonary infections caused by these fungi range from airway colonization to invasive disease, with potential for dissemination, especially to the brain.
  • Infections manifest differently in immunocompetent versus immunocompromised individuals.

Purpose of the Study:

  • To review and analyze reported cases of Pseudallescheria/Scedosporium pulmonary infections.
  • To investigate geographical distribution, host immune status, infection types, clinical presentations, treatments, and outcomes.
  • To understand the spectrum of pulmonary disease caused by these fungi.

Main Methods:

  • Systematic review of published literature on Pseudallescheria/Scedosporium pulmonary infections.
  • Analysis of 189 reported cases.
  • Categorization of infections based on clinical manifestations, host immune status, and underlying conditions.

Main Results:

  • Pneumonia was the most common manifestation (89 cases), followed by fungus balls (26) and chest abscesses (18).
  • Near-drowning was associated with pneumonia in immunocompetent hosts.
  • Preexisting lung cavities and immunosuppression were linked to non-invasive and invasive pulmonary infections, respectively. Cystic fibrosis patients often presented with saprobic colonization.

Conclusions:

  • Pulmonary pseudallescheriasis presents with diverse clinical forms, including pneumonia, fungus balls, and abscesses.
  • Mortality rates were significantly higher in invasive infections (57.2%) compared to non-invasive types (26.8%).
  • Understanding host factors and infection type is crucial for managing these serious fungal infections.

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