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Cerebral Scedosporium apiospermum infection presenting with intestinal manifestations

D Lin1, Q Kamili, K Qurat-Ul-Ain

  • 1Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA. derekl@bcm.edu

Infection
|February 27, 2013
PubMed

Insights

Scedosporium apiospermum, a fungal infection, can cause brain abscesses and colitis in immunosuppressed patients, particularly after liver transplants. Early diagnosis and treatment are crucial for managing this rare but serious condition.

Area of Science:

  • Mycology
  • Infectious Diseases
  • Transplantation Medicine

Background:

  • Scedosporium apiospermum is an opportunistic mold.
  • Immunosuppression, particularly after organ transplantation, increases susceptibility to fungal infections.
  • Cerebral and gastrointestinal fungal infections are serious complications in immunocompromised individuals.

Observation:

  • A 64-year-old liver transplant recipient presented with chronic diarrhea and colonic ulcers.
  • The patient developed a seizure due to a left frontal brain abscess.
  • Cultures identified Scedosporium apiospermum as the causative agent for both cerebral and gastrointestinal symptoms.

Findings:

  • This case describes Scedosporium apiospermum causing both cerebral and intestinal disease, a presentation not previously documented.
  • The fungal morphology is similar to Aspergillus, potentially leading to misdiagnosis in histopathology.
  • Successful treatment involved surgery, voriconazole, and liposomal amphotericin.

Implications:

  • Scedosporium apiospermum should be considered in immunosuppressed patients with combined neurological and gastrointestinal symptoms.
  • This case highlights the need for careful histopathological review to differentiate Scedosporium from Aspergillus.
  • The findings expand the known clinical spectrum of Scedosporium apiospermum infections.

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