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Osteitis of the Temporal Bone
Published in John C Watkinson, Raymond W Clarke, Christopher P Aldren, Doris-Eva Bamiou, Raymond W Clarke, Richard M Irving, Haytham Kubba, Shakeel R Saeed, Paediatrics, The Ear, Skull Base, 2018
Cheka R. Spencer, Peter Monksfield
Fungal infections are more commonly associated with the immunocompromised (e.g. HIV/AIDS) than with diabetics. In contrast to pseudomonal skull base osteomyelitis, these originate more often in the middle ear or mastoid. Aspergillus fumigatus, is the most common fungal organism isolated. It is associated with a worse prognosis than Pseudomonas when it is the causative agent. Others include Aspergillus niger, Aspergillus flavus, Candida sp., Malassezia sympodialis and Scedosporium apiospermum.5–7,9,12–15,17
Pulmonary complications of solid-organ transplantation
Published in Philippe Camus, Edward C Rosenow, Drug-induced and Iatrogenic Respiratory Disease, 2010
While Aspergillus species account for the majority of invasive fungal infections of the lung in solid-organ transplant recipients, myriad other fungal organisms can cause pulmonary disease. These include Cryptococcus neoformans, the zygomycetes (especially Muror species), and the geographically restricted endemic fungi (Histoplasma capsulatum, Coccidiodes immitus and Blastomyces dermatitidis). In general, the presenting features of these fungal infections are neither clinically nor radiographically distinct and all have the potential to cause disseminated disease in addition to pneumonia. Candida species are responsible for a number of serious post-transplant infections, including sepsis, intra-abdominal abscesses and urinary tract infections, but involvement of the lungs is conspicuously rare. The one notable exception to this is infection of the bronchial anastomosis that occasionally occurs following lung transplantation. An emerging pulmonary pathogen is Scedosporium apiospermum (previously known as Pseudallescheria boydii). This organism has been documented to cause infection in all of the major solid-organ transplant populations.36 Invasive pulmonary disease is a feature in approximately 50 per cent of cases; central nervous system and endovascular involvement as well as widespread dissemination are also common.36 In distinction from the other fungal pathogens discussed above, Scedosporium is frequently resistant to amphotericin B; voriconazole is the preferred agent.
Epidemiology of fungal infections: What, where, and when
Published in Mahmoud A. Ghannoum, John R. Perfect, Antifungal Therapy, 2019
Frederic Lamoth, Sylvia F. Costa, Barbara D. Alexander
Species of the genus Scedosporium are frequently encountered in soil from rural areas, parks, potted plants, from compost, manure of cattle and fowl, polluted waters and sewage, and occasionally from hospital air during construction [5,70,71,112]. Infections are caused by species of the Scedosporium apiospermum complex (including S. apiospermum, S. boydii and its sexual form Pseudallescheria boydii, and S. auranthiacum). S. prolificans, actually reassigned to a new genus as Lomentospora prolificans, has occasionally been designated as a dematiaceous mold and is characterized by resistance to virtually all antifungal classes [113]. The first case of L. prolificans infection was reported in 1984 [114]. Since that time, multiple cases have been reported in the literature, with fairly large case series from Spain, Australia, and the United States [115–118]. SOT recipients, especially lung-transplant recipients, seem to be particularly susceptible to Scedosporium colonization and infection [119–121]. In one series, approximately 66% of the patients with L. prolificans infection were receiving amphotericin B prior to the infection [122]. In a series from a tertiary care cancer center, the incidence of Scedosporium infection increased from 0.82 cases per 100,000 patient-inpatient days (1993–1998) to 1.33 cases per 100,000 patient-inpatient days, with all cases of S. prolificans presenting as breakthrough infections after the year 2000 [123]. In a series of 162 cases of L. prolificans infections, major risk factors were malignancy (45%), cystic fibrosis (11%) and SOT (8%) [124]. Most common clinical presentations were disseminated infections (44%), pulmonary infections (29%) and bone and joint infections (10%). Fungemia was present in 70% of cases of systemic infections and overall mortality was 47%. The increase in S. prolificans infections may be linked to the increasing use of antifungal prophylaxis, which in turn may select for this opportunistic pathogen that is notoriously resistant to practically all antifungal agents.
Efficacy and safety of Isavuconazole for the treatment of invasive Aspergillus infection - an update of the literature
Published in Expert Opinion on Pharmacotherapy, 2022
Geetha Sivasubramanian, Pranatharthi H Chandrasekar
ISZ is currently not approved for prophylaxis against IFIs. However, given its broad spectrum of activity, favorable pharmacokinetics, and safety profile, ISZ is being used off-label in many centers for anti-fungal prophylaxis. Preliminary studies were concerning for development of breakthrough IFIs with the use of ISZ. In a report by Fung et al., ISZ was used at standard dosing for primary and secondary prophylaxis against IFIs when VCZ or POS use was contraindicated [71]. They reported five breakthrough infections which were microbiologically confirmed as due to Aspergillus nigri group, Rhizopus spp., Scedosporium apiospermum, and Aspergillus fumigatus. Treatment escalation was needed in all the patients and three out of the five succumbed to the infection.
Biofilms formed by Scedosporium and Lomentospora species: focus on the extracellular matrix
Published in Biofouling, 2020
Thaís P. Mello, Marta H. Branquinha, André L. S. Santos
Scedosporium apiospermum (strain RKI07_0416) was kindly provided by Dr Bodo Wanke (Evandro Chagas Hospital, Oswaldo Cruz Institute, FIOCRUZ, Rio de Janeiro, Brazil), and S. minutisporum (strain FMR 4072), S. aurantiacum (strain FMR8630) and L. prolificans (strain FMR 3569) were kindly given by Dr Josep Guarro (Microbiology Unit, Medical School and Institute of Advanced Studies, Reus, Spain). The fungi were maintained in Sabouraud (2% glucose, 1% peptone and 0.5% yeast extract) liquid culture medium for 7 days at room temperature with orbital shaking (200 rpm). To obtain the conidial cells, each fungus was grown at room temperature in Petri dishes containing potato dextrose agar (PDA; Difco Laboratories, USA). Subsequently, conidia were obtained by washing the plate surfaces with phosphate-buffered saline (PBS; 10 mM NaH2PO4, 10 mM Na2HPO4, 150 mM NaCl, pH 7.2) and filtering them through a 40-µm nylon cell strainer (BD Falcon, EUA) in order to remove the hyphal fragments (Mello et al. 2016a,b). The conidial cells were counted in a Neubauer chamber.
Advances in understanding and managing Scedosporium respiratory infections in patients with cystic fibrosis
Published in Expert Review of Respiratory Medicine, 2020
Jean-Philippe Bouchara, Yohann Le Govic, Samar Kabbara, Bernard Cimon, Rachid Zouhair, Monzer Hamze, Nicolas Papon, Gilles Nevez
Until the early 2000s, only two species were recognized in the genus Scedosporium: Scedosporium apiospermum (formerly Monosporium apiospermum, and initially considered as the asexual state of Pseudallescheria boydii, formerly Allescheria boydii) and Scedosporium prolificans (formerly Scedosporium inflatum) which reproduces exclusively under an asexual state [10]. Nevertheless, regarding Scedosporium apiospermum, a great variability could be seen from strains to strains in the macroscopic and microscopic morphology, in agreement with the high polymorphism found in the first genotype studies performed on this fungus [11–13]. Important taxonomic studies were therefore conducted by Gilgado et al. [14–16]; by comparison of 60 epidemiologically unrelated isolates morphologically, physiologically and on the molecular level (sequencing of the internal transcribed spacer – ITS – regions 1 and 2 of ribosomal DNA – rDNA-, of the calmodulin gene, and of two loci in the beta-tubulin gene – TUB and BT2), Gilgado et al. [14–16] demonstrated that Scedosporium apiospermum and Pseudallescheria boydii are two distinct entities, and three new species were described, namely Scedosporium dehoogii, Pseudallescheria minutispora and Scedosporium aurantiacum.