ABSTRACT
Scedosporium apiospermum is a cosmopolitan mycotic agent with unique characteristics. This is a case of a 65-year-old immunocompetent patient who presented with shortness of breath and fever. Consolidation was observed in both lung fields on chest X-ray. A diagnosis of aspiration pneumonia was made. Extended-spectrum β-lactamase (ESBL)-producing Klebsiella pneumoniae was identified from his tracheal aspirate and imipenem was administered. Initial blood cultures were negative but after 10 days on imipenem, Candida glabrata was isolated. Amphotericin B was added to the treatment regimen, but after a week on this antifungal, Scedosporium apiospermum was cultured from the blood. The patient succumbed to illness before a change in the antifungal regimen. The case highlights the unwelcome consequence of using a broad spectrum antibiotic and later a broad spectrum antifungal agent.
ABSTRACT
ObjectiveTore-identifyfifteenclinical Pseudallescheriaboydii/Scedosporium apiospermum isolates by the sequence difference of ITS rDNA and partial β-tubulin gene (TUB) and thus understand thepathogenicstrain typesfor guiding theclinicaltreatment.MethodsMorphological appearances,D-ribose assimilation and sequencing of ITS and TUB were used to re-identify the fifteen clinical strains of Pseudallescheria boydii/Scedosporium apiospermum.The sequences of ITS and TUB were analyzed with Clustal X and MEGA 4 software.Results No difference of morphological appearances was found in the fifteen strains.Cleistothecium was observed in one isolate.All the strains were D-ribose assimilation positive.The clinical strains were re-identified as P.boydii species complex by the CBS database (http://www.cbs.knaw.nl).ElevenstrainswereP.boydiiandfourstrainswereS.apiospermum respectively.Conclusions P.boydii and S.apiospermum cannot be identified correcdy by the time-consuming conventional morphological method and biochemical characteristics.The study recommend that the clinical isolates of P.boydii and S.apiospermum should be identified utilizing a combination of traditional phenotype method and molecular biotechnology.
ABSTRACT
We report a case of pulmonary fungal ball of Pseudallescheria boydii (Scedosporium apiospermum, the anamorph) and the result of LSU rDNA D2 region sequencing of the clinical isolate. An immunocompetent 58-year-old female suffered 2-year history of hemoptysis. Her symptom persisted despite the administration of oral itraconazole, even though the clinical, radiological, and histological findings suggested Aspergilloma. In the fungal culture, the typical morphology of S. apiospermum was observed. Even though the sequencing using LSU rDNA D2 region identified the organism as Pseudallescheria ellipsoidea, one of the P. boydii complex, the further investigation of ours suggested that the species in P. boydii complex could not be differentiated from each other by the sequencing of LSU rDNA D2 region.
Subject(s)
Female , Humans , Middle Aged , DNA, Ribosomal , Hemoptysis , Itraconazole , Pseudallescheria , ScedosporiumABSTRACT
· We report successful treatment of a case of fungal keratitis caused by Pseudallescheria boydii with minimal corneal scar. A 71-year-old woman with history of pain, redness and foreign body sensation presented to our tertiary eye center. Initial corneal scraping revealed fungal elements. After two days fungal culture became positive, and after five days it was shown to be growth of Pseudallescheria boydii. The patient achieved clinical cures with medical therapy alone with minimal corneal scar and good visual outcome of 3/10.
ABSTRACT
Scedosporium apiospermum is the asexual stage of Pseudallescheria boydii that is ubiquitous in nature. The localized cutaneous abscess due to S. apiospermum is rare and it is usually originated from the traumatic inoculation of fungal elements. We report a case of cutaneous abscess caused by S. apiospermum. A 67-year-old woman presented with one-year history of subcutaneous nodules on the left forearm, which had been misdiagnosed as cutaneous tuberculosis. Cultural isolation for definitive diagnosis showed typical S. apiospermum.
Subject(s)
Aged , Female , Humans , Abscess , Diagnosis , Forearm , Pseudallescheria , Scedosporium , Tuberculosis, CutaneousABSTRACT
Infection by pseudallescheria boydii is an occasional cause of mycetoma, corneal ulcers, endophthalitis, sinusitis, pneumonia, endocarditis, meningitis, arthritis, and osteomyelitis. But, it also causes serious disseminated or localized infection in immunocompromised patients. We report a case of pulmonary pseudallescheriasis developed in a 32-year-old man who has been a sofa manufacturer for several years. He presented with a cystic mass in the lung, 5cm in the largest dimension. Dark green necrotic material was evacuated from the cavity. Microscopically, the cystic wall and adjacent lung parenchyme were infiltrated by histiocytes rather than eosinophils and there was little fibrosis in the wall. The P. boydii was isolated from the cystic contents, which revealed white floccose colonies in Sabouraud dextrose agar and revealed single or multiple-celled oval conidia being produced on short hyalinated hyphae and on the elongated annellides in the slide culture. The differential findings with aspergillosis are discussed.