Invasive Scedosporium sternal osteomyelitis following lung transplant: Cured

Area of Science:

• Medical Mycology
• Infectious Diseases
• Transplantation Immunology

Background:

• Scedosporium species are opportunistic fungi, posing significant risks to immunocompromised individuals, especially those with cystic fibrosis (CF) and organ transplant recipients.
• Invasive infections caused by Scedosporium are uncommon but notoriously difficult to treat due to inherent antifungal resistance.
• Lung transplant recipients with CF represent a vulnerable population for invasive fungal infections.

Purpose of the Study:

• To report a rare case of invasive Scedosporium infection in a cystic fibrosis patient following lung transplantation.
• To highlight the treatment challenges and successful management strategy for invasive Scedosporium sternal and rib infection.
• To emphasize the role of surgical intervention and prolonged antifungal therapy in managing such infections.

Main Methods:

• A case study of a young male cystic fibrosis patient 10 months post-lung transplant.
• Diagnosis of invasive sternal and rib infection.
• Treatment involved extensive surgical debridement and prolonged triazole antifungal therapy.

Main Results:

• The patient achieved clinical and radiological cure of the invasive Scedosporium infection.
• The combined approach of extensive surgery and triazole therapy proved effective.
• No recurrence of infection was observed during follow-up.

Conclusions:

• Invasive Scedosporium infections, though rare, require aggressive management in immunosuppressed patients.
• Adjunctive surgical intervention is crucial for successful outcomes in invasive Scedosporium infections.
• Prolonged triazole therapy, in conjunction with surgery, is a viable strategy for treating invasive Scedosporium sternal and rib infections in lung transplant recipients.