Scedosporium apiospermum causing brain abscess in a renal allograft recipient

Area of Science:

• Mycology
• Infectious Diseases
• Transplant Surgery

Background:

• Scedosporium apiospermum, the asexual form of Pseudallescheria boydii, is a rare fungus found in soil and contaminated water.
• Disseminated infections by Scedosporium apiospermum are uncommon but pose a significant threat to immunocompromised individuals.

Observation:

• A renal allograft recipient presented with fever post-transplant, initially diagnosed with dengue fever.
• The patient rapidly deteriorated, developing neurological symptoms indicative of multiple brain abscesses.
• Fungal elements of Scedosporium apiospermum were identified in drained abscess material.

Findings:

• The case highlights a rare instance of disseminated Scedosporium apiospermum infection presenting as multiple brain abscesses in a kidney transplant recipient.
• Despite voriconazole treatment and surgical drainage, the patient succumbed to the infection.

Implications:

• Scedosporium apiospermum should be considered in the differential diagnosis of disseminated infections, especially brain abscesses, in transplant recipients.
• High mortality rates associated with Scedosporium infections in this population underscore the need for heightened clinical suspicion and prompt management.