Scedosporium aurantiacum: First isolation in Argentina from a previously healthy patient after traumatic inoculation / Scedosporium aurantiacum: primer aislamiento en Argentina de un paciente previamente sano después de una inoculación por un traumatismo

Abstract Scedosporium/Lomentospora species are widely distributed in nature. They are gen-erally saprophytes, but can cause opportunistic infections in immunocompromised patients and occasionally in immunocompetent patients that are difficult to treat due to high lev-els of antifungal resistance. The distribution of Scedosporium/Lomentospora species shows regional differences. Scedosporium boydii and Scedosporium apiospermum are the most fre-quently isolated species in our region, whereas Scedosporium aurantiacum is more common in other regions. We describe the first isolation in Argentina of S. aurantiacum in a vitreous humor infection from a previously healthy patient after traumatic injury in her left eye. Due to the suspicion of fungal endophthalmitis, a mycological study of the vitreous humor was performed. The culture allowed the isolation of S. aurantiacum. The patient was treated with voriconazole with favorable clinic evolution.

Resumen Las especies de Scedosporium/Lamentospora se encuentran ampliamente distribuidas en la naturaleza. En general son saprofitas, pero pueden causar infecciones oportunistas de difícil tratamiento debido a sus altos niveles de resistencia a los antifúngicos en individuos inmunocomprometidos y, ocasionalmente, en personas inmunocompetentes. La distribución de las especies de Scedosporium/Lamentospora muestra diferencias regionales. Scedosporium boydii y S. apiospermum son las especies más frecuentemente aisladas en nuestra región, mientras que en otras S. aurantiacum es más común. Presentamos el primer aislamiento en Argentina de S. aurantiacum de una infección de humor vítreo de un paciente previamente sano que sufrió una lesión traumática. El paciente fue tratado con voriconazol y tuvo una evolución clínica favorable.

Scedosporiosis pulmonar post COVID-19 en paciente diabético: a propósito de un caso

Las especies de Scedosporium son consideradas patógenos oportunistas emergentes, que afectan a pacientes inmunocomprometidos o con respuesta inmunológica normal. La enfermedad invasiva grave supera tasas de mortalidad del 80 %. Se describe caso con afectación pulmonar causada por el complejo de especies de Scedosporium en un paciente masculino de 75 años de edad, procedente de Caracas, Venezuela, con diabetes mellitus tipo 2, infección respiratoria baja, dos infecciones previas por enfermedad por coronavirus 2019 (COVID-19) e imagen radiológica de lesión de ocupación de espacio pulmonar basal izquierdo. Se envió al laboratorio de microbiología porción de aproximadamente 1 cm2 de tejido pulmonar, solicitando estudios micológicos y para micobacterias. Al examen directo con KOH al 20 % se observó un fragmento de hifa hialina tabicada. A los 12 días de incubación hubo crecimiento en agar Sabouraud dextrosa más gentamicina de colonias vellosas con pigmentado difusible color amarillo pálido a mostaza. Se realizó examen directo a las colonias con azul de algodón, observándose estructuras compatibles con el complejo de especies de Scedosporium. Scedosporium spp., es el segundo hongo filamentoso, después de Aspergillus spp., causante de infecciones respiratorias bajas. El paciente fue tratado con voriconazol después del diagnóstico micológico con una evolución satisfactoria. Las infecciones por especies de Scedosporium afectan órganos internos como los pulmones, similar al caso descrito. La infección por COVID-19 es un factor predisponente para adquirir infecciones fúngicas poco frecuentes. El laboratorio de microbiología cumple un rol importante en el diagnóstico de micosis causadas por hongos inusuales.

Scedosporium species are considered emerging opportunistic pathogens affecting immunocompromised patients or patients with normal immune response. Mortality rates exceed 80 % in severe invasive disease. We describe a case of lung involvement caused by Scedosporium species complex in a 75-year-old male patient from Caracas, Venezuela, with type 2 diabetes mellitus, lower respiratory tract infection, two previous coronavirus disease infections 2019 (COVID-19) and radiological findings of a left basal lung space-occupying lesion. A piece of lung tissue measuring approximately one cm2 was sent to the microbiology laboratory, requesting mycology and mycobacteria studies. Direct examination with 20 % KOH revealed a hyaline septate hyphal fragment. Growth of hairy colonies with diffusible pale yellow to mustard pigment was observed on Sabouraud dextrose plus gentamicin agar after 12 days of incubation. Structures compatible with the Scedosporium species complex were observed on direct examination of the colonies with cotton blue. Scedosporium spp. is the second most common filamentous fungus causing infections of the lower respiratory tract after Aspergillus spp. The patient was treated with voriconazole after mycological diagnosis with satisfactory outcome. Infections with Scedosporium spp. affect internal organs such as the lungs, similar to the case described. COVID-19 infection predisposes to the acquisition of uncommon fungal infections. The microbiology laboratory plays an important role in the diagnosis of mycoses caused by unusual fungi.

Infección de cavidad anoftálmica por Scedosporium sp. en paciente inmunocompetente: Reporte de caso / Anophthalmic socket infection caused by Scedosporium sp. in immunocompetent patient: Case Report

Resumen Scedosporium sp. es un género de hongos filamentosos que de forma infrecuente se relaciona a infecciones localizadas o diseminadas en pacientes inmunocom prometidos, o inmunocompetentes con trauma penetrante contaminado. Reportamos el caso de un paciente masculino de 31 años con antecedente de trauma penetrante por arma de fuego requiriendo enucleación de su ojo izquierdo, quien 12 años posterior al trauma inicial presenta necrosis de la cavidad anoftálmica con extrusión del implante y lisis del párpado inferior, finalmente identificando Scedosporium sp. como germen causal, y un mucocele en el seno frontal como reservorio. El paciente recibió tratamiento médico con voriconazol sistémico, desbridamiento quirúrgico amplio, y resección endoscópica del quiste de retención mucoso, con una evolución satisfactoria. Las infecciones micóticas de la cavidad anoftálmica son infrecuentes, requiriendo una alta sospecha diagnóstica y trata miento agresivo para evitar consecuencias potencialmente devastadoras.

Abstract Scedosporium sp. is a genus of filamentous fungi that is infrequently related to localized or disseminated infections in either immunocompromised patients, or immunocompetent patients with penetrating contaminated trauma. We report the case of a 31-year-old patient with a history of penetrating gunshot wound that required enucleation of his left eye, who 12 years after initial trauma presents necrosis of the anophthalmic socket with implant extrusion and lysis of inferior eyelid, finally identifying the causal agent to be Scedosporium sp. The patient received medical treatment with systemic voriconazole, and wide surgical debridement, with a satisfactory evolution. Fungal infections of anophthalmic sockets are infrequent, requiring a high diagnostic suspicion and aggressive treatment to avoid potentially devastating consequences.

Infección ocular invasora por Scedosporium apioespermum en un paciente inmunocomprometido / Invasive ocular fungal infection by Scedosporium apiospermum in an immunocompromised patient

Resumen Presentamos el caso clínico de una infección fúngica invasora con una conjuntivitis necrosante, escleritis y panuveitis unilateral por Scedosporium apiospermum en una mujer de 78 años con artritis reumatoidea con neutropenia secundaria a fármacos. El diagnóstico etiológico fue confirmado por cultivo micológico de secreción ocular con apoyo de MALDI-TOF-TOF e histopatología. El tratamiento incluyó aseos quirúrgicos asociado a terapia tópica y sistémica con voriconazol y corticoesteroides, con una evolución favorable a los dos meses de tratamiento. Una recaída obligó a un segundo curso terapéutico por 12 meses adicionales con mejoría y erradicación del agente. La conjuntivitis fúngica por S. apiospermum es un evento infrecuente asociado a pacientes inmunocomprometidos. Su tratamiento involucra desbridamientos quirúrgicos y terapia antifúngica prolongada.

Abstract We report a case of invasive fungal infection with necrotizing conjunctivitis, scleritis and unilateral panuveitis caused by Scedosporium apiospermum in a 78-year-old woman that developed neutropenia by drugs indicated for rheumatoid arthritis. The etiological diagnosis was confirmed by mycological culture of an ocular secretion with the support of MALDI-TOF-TOF analysis and histopathological findings. The treatment involved surgical debridements together with topical solution and systemic therapy with voriconazole and steroids with a favorable evolution after 2 months of treatment. A relapse required a second therapeutic course for an additional 12 months with improvement and eradication of the agent. Fungal conjunctivitis due to S. apiospermum is a rare event associated with immunosuppressed patients. Its treatment involves surgical debridements and prolonged antifungal therapy.

Osteomielitis por Scedosporium spp., a propósito de un caso / Scedosporium spp. osteomyelitis: A case report

Resumen Scedosporium es un hongo de distribución mundial que se encuentra en el suelo y enaguas contaminadas. Raramente afecta tejido óseo y puede hacerlo por inoculación directa através de traumatismos. Se presenta el caso clínico de un paciente de 54 a˜nos con antecedentede accidente acuático y fractura expuesta de tibia-peroné de ambos miembros inferiores, condiagnóstico de osteomielitis crónica bacteriana tratada con antibióticos de amplio espectropor 120 días. Luego de ocho meses iniciado el cuadro, se aísla Scedosporium spp. en colecciónde miembro afectado; por tal motivo, el paciente recibe terapia con voriconazol asociado aterbinafina.© 2019 Asociacion Argentina de Microbiologıa. Publicado por Elsevier Espana, S.L.U. Este es unarticulo Open Access bajo la licencia CC BY-NC-ND (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Abstract Scedosporium is a fungus that has a worldwide distribution, and which can be foundin soil and contaminated water. It can rarely affect bone tissue and can do it either by directinoculation or through trauma. We present here a case of a 54- year- old male patient with adiagnosis of chronic bacterial osteomyelitis due to an aquatic accident and exposed fracture of tibia-fibula of both members, which was treated with broad-spectrum antibiotics for 120days. Eight months after the onset of the disease, Scedosporium spp. was isolated from thecollection of one of the affected member, which was treated with voriconazole in combinationwith terbinafine.© 2019 Asociacion Argentina de Microbiologıa. Published by Elsevier Espana, S.L.U. This is anopen access article under the CC BY-NC-ND license (https://creativecommons.org/licenses/by-nc-nd/4.0/).

In vitro biological activities of silver nanoparticles synthesized from Scedosporium sp. isolated from soil

One of the important fields in nanotechnology is the development of an environment friendly method for the synthesis of nanoparticles. Many approaches show that microorganisms are the most reliable tools for biosynthesis of nanoparticles compared to physical and chemical methods. In our study, fungi have been exploited for extracellular production of metal nanoparticles. It was observed that in Scedosporium, silver ions are reduced to silver nanoparticles, which was confirmed by UV-visible spectrophotometry and AFM. Optimization studies showed that as the concentration of AgNO3 used for synthesis increased, particles' size also increased. Size of the particles at different concentrations of AgNO3 was observed to be 79-107 nm with particles being ellipsoidal to spherical in shape. Silver nanoparticles synthesized from 2.0 mM silver nitrate, showed maximum antimicrobial activity compared to all antibiotics tested including synergistic effects. In vitro cytotoxicity of silver nanoparticles against MCF 7 and PC 3 showed that as the concentration of silver nanoparticles increased, a decrease in the percentage cell viability was observed with IC50 values being 60.09 and 57.43 µg/ml respectively. Therefore, through this study, it could be said that extracellular synthesis of silver nanoparticles from Scedosporium was simple, ecofriendly, proving excellent antimicrobial and anticancer agents.

Ocular infections caused by Scedosporium apiospermum: A case series

The aim of our retrospective study is to report a case series of ocular infections caused by a rare fungus, Scedosporium apiospermum, in a South Indian population. Thirteen cases of culture-positive S. apiospermum infections diagnosed between January 2011 and March 2016 were included in this study. The parameters evaluated were predisposing factors, treatment and final clinical outcome. The most common mode of presentation was keratitis (84.6%) followed by sclerokeratitis (15.3%). The predisposing factors involved were unspecified foreign body injury (30.7%), organic matter injury (15.3%), uncontrolled diabetes (7.6%), and recent manual small-incision cataract surgery (7.6%). Five cases (38.46%) had no predisposing factor. Of the 11 keratitis cases, nine (69.2%) responded well to combination medical therapy while one case (7.6%) required therapeutic keratoplasty. One case was lost to follow-up. Both cases which presented with sclerokeratitis showed no response to medico-surgical treatment progressing to panophthalmitis and evisceration.

Ultrastructural viewpoints on the interaction events of Scedosporium apiospermum conidia with lung and macrophage cells

BACKGROUND Scedosporium apiospermum is a ubiquitous, emerging and multidrug-resistant fungal pathogen with still rather unknown virulence mechanisms. OBJECTIVES/METHODS The cellular basis of the in vitro interaction between fungi and host cells/tissues is the determinant factor for the development of a successful in vivo infection. Herein, we evaluated the interaction of S. apiospermum conidia with lung epithelial (A549), lung fibroblast (MRC-5) and RAW 264.7 macrophages by light and scanning/transmission electron microscopy. FINDINGS After 4 h of fungi-host cell contact, the percentage of infected mammalian cells and the number of fungi per infected cell was measured by light microscopy, and the following association indexes were calculated for A549, MRC-5 and macrophage cells: 73.2 ± 25.9, 69.7 ± 22.5 and 59.7 ± 11.1, respectively. Both conidia and germinated conidia were regularly observed interacting with the evaluated cells, with a higher prevalence of non-germinated conidia. Interestingly, nests of germinated conidia were evidenced at the surface of lung cells by scanning electron microscopy. Some germination projections and hyphae were seen penetrating/evading the mammalian cells. Furthermore, internalised conidia were seen within vacuoles as visualised by transmission electron microscopy. MAIN CONCLUSIONS The present study contributes to a better understanding of S. apiospermum pathogenesis by demonstrating the first steps of the infection process of this opportunistic fungus.

Scedosporium apiospermum, Scedosporium aurantiacum, Scedosporium minutisporum and Lomentospora prolificans: a comparative study of surface molecules produced by conidial and germinated conidial cells

BACKGROUND Scedosporium/Lomentospora species are opportunistic mould pathogens, presenting notable antifungal resistance. OBJECTIVES/METHODS We analysed the conidia and germinated conidia of S. apiospermum (Sap), S. aurantiacum (Sau), S. minutisporum (Smi) and L. prolificans (Lpr) by scanning electron microscopy and exposition of surface molecules by fluorescence microscopy. FINDINGS Conidia of Sap, Smi and Sau had oval, ellipsoidal and cylindrical shape, respectively, with several irregularities surrounding all surface areas, whereas Lpr conidia were rounded with a smooth surface. The germination of Sap occurred at the conidial bottom, while Smi and Sau germination primarily occurred at the centre of the conidial cell, and Lpr germination initiated at any part of the conidial surface. The staining of N-acetylglucosamine-containing molecules by fluorescein-labelled WGA primarily occurred during the germination of all studied fungi and in the conidial scars, which is the primary location of germination. Calcofluor white, which recognises the polysaccharide chitin, strongly stained the conidial cells and, to a lesser extent, the germination. Both mannose-rich glycoconjugates (evidenced by fluoresceinated-ConA) and cell wall externally located polypeptides presented distinct surface locations and expression according to both morphotypes and fungal species. In contrast, sialic acid and galactose-containing structures were not detected at fungal surfaces. MAIN CONCLUSIONS The present study demonstrated the differential production/exposition of surface molecules on distinct morphotypes of Scedosporium/Lomentospora species.

Clinical manifestation and laboratory examinations of invasive Scedosporium infection / 临床检验杂志

Objective To investigate the clinical manifestation and the characteristics of laboratory examinations of invasive Scedocporium infection.Methods The clinical data of 8 patients infected with Scedosporium from January 2011 to April 2017 were collected and retrospective analysis combined with related literatures was performed.Results Among the 8 patients,6 strains of S.apiospermum,1 strains of Peudallescheria boydii and 1 strains of S.prolificans were detectable.The predisposing factors of Scedosporium infection were trauma,environmental exposure and hypoimmunity.The septahypha in specimens could be direcdy observed under microscopic examination with positive rate 100％.The growth speed of cultured colony was relatively fast and the invasiveness was strong.The colony of Scedosporium displayed various forms from white cashmere to black yeast sample.The color was gradually become dark from the center of colony with lengthening time of cultivation.Scedosporium could be identified by microscopic morphology combining culture technique.Conclusion The course of invasive Scedosporium infection may progress rapidly with serious and dangerous illness state.The most common infection of Scedosporium should be induced by S.apiospernum.The knowledge and understanding for Scedosporium infection should be strengthened to improve the level of diagnosis and treatment.

Conidial germination in Scedosporium apiospermum, S. aurantiacum, S. minutisporum and Lomentospora prolificans: influence of growth conditions and antifungal susceptibility profiles

In the present study, we have investigated some growth conditions capable of inducing the conidial germination in Scedosporium apiospermum, S. aurantiacum, S. minutisporum and Lomentospora prolificans. Germination in Sabouraud medium (pH 7.0, 37ºC, 5% CO2) showed to be a typically time-dependent event, reaching ~75% in S. minutisporum and > 90% in S. apiospermum, S. aurantiacum and L. prolificans after 4 h. Similar germination rate was observed when conidia were incubated under different media and pHs. Contrarily, temperature and CO2 tension modulated the germination. The isotropic conidial growth (swelling) and germ tube-like projection were evidenced by microscopy and cytometry. Morphometric parameters augmented in a time-dependent fashion, evidencing changes in size and granularity of fungal cells compared with dormant 0 h conidia. In parallel, a clear increase in the mitochondrial activity was measured during the transformation of conidia-into-germinated conidia. Susceptibility profiles to itraconazole, fluconazole, voriconazole, amphotericin B and caspofungin varied regarding each morphotype and each fungal species. Overall, the minimal inhibitory concentrations for hyphae were higher than conidia and germinated conidia, except for caspofungin. Collectively, our study add new data about the conidia-into-hyphae transformation in Scedosporium and Lomentospora species, which is a relevant biological process of these molds directly connected to their antifungal resistance and pathogenicity mechanisms.

Surviving a recurrent Scedosporium prolificans endocarditis : A case report.

Scedosporium prolificans have been reported to be resistant to all antifungals including the newer azoles and echinocandins. We report an unusual case of repeated S. prolificans infection of the heart valves in an immunocompetent patient.

Infección pulmonar no invasora por Scedosporium apiospermum / Pulmonary non invasive infection by Scedosporium apiospermum

We reported a case of non-invasive pulmonary infection by Scedosporium apiospermum in 67 years old female with bronchiectasis and caverns secondary to tuberculosis. Diagnosis was made with lung CT and bronchial lavage cultures. The patient was initially treated with itraconazole for six weeks without success and then voriconazole for 16 weeks, with good clinical response.

Reportamos el caso clínico de una infección pulmonar no invasora por Scedosporium apiospermum en una mujer de 67 años de edad, con bronquiectasias y cavernas pulmonares secundarias a una tuberculosis. El diagnóstico se realizó con la TAC pulmonar y cultivos de lavado bronquial. La paciente fue tratada inicialmente con itraconazol oral por seis semanas sin respuesta y luego voriconazol vía oral por 16 semanas, con una buena respuesta clínica.

Invasive lung infection by Scedosporium apiospermum in an immunocompetent individual.

Scedosporium apiospermum previously known as Monospermum apiospermum is a ubiquitous fungus found in soil, polluted water and sewage. It causes broad spectrum of diseases, including soft tissue infections, septic arthritis, osteomyelitis, ophthalmic infections, sinusitis, pneumonia, meningitis, brain abscesses, endocarditis and disseminated infection. In recent years, it has been shown to be pathogenic for both immunocompetent and immunosuppressed patients. It is a signifi cant opportunist with very high levels of antifungal resistance. We report here a case of invasive lung infection due to S. apiospermum in an immunocompetent patient who responded to antifungal therapy and surgical treatment.

Scedosporium apiospermum fungaemia: the ramification of broad spectrum antimicrobial treatments.

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.

A Case of Localized Skin Infection Due to Scedosporium apiospermum Diagnosed by DNA Sequencing of the Internal Transcribed Spacer Region / 대한의진균학회지

Scedosporium apiospermum is an asexual state of Pseudallescheria boydii which has been isolated from soil, sewage, and decaying vegetation. It can cause cutaneous infections by traumatic implantation of the contaminant due to penetrating injury. This ubiquitous fungus cause not only mycetoma, but also infections of variety of body sites including the skin. The localized skin infection due to this organism is much rare than mycetoma. We report a case of cutaneous S. apiospermum infection occurred in 80-year-old male. The skin lesion was manifested by a 8.0 x 4.0 cm-sized erythematous plaque with pustules and crusts on the dorsum of right hand. The fungal culture from the biopsy specimen on Sabouraud's dextrose agar showed white to gray colored cottony colonies of S. apiospermum. The nucleotide sequence of internal transcribed spacer for clinical isolate was identical to that of S. apiospermum strain IHEM 23829. The patient was treated with oral fluconazole for 3 months.

Unusual causes of fungal rhinosinusitis: A study from a tertiary care centre in South India.

Purpose: The frequency of mycotic infections of the nose and paranasal sinuses has been increasing over the past three decades. Apart from the common causes of fungal rhinosinusitis such as Aspergillus species and Penicillium species, there have been reports of rare and unusual fungi isolated from India and other countries. Objective: The objective of this study is to fi nd out the prevalence of fungal infections of the nose and paranasal sinuses caused by unusual fungal isolates at a tertiary care teaching hospital in South India. Materials and Methods: Duration of the study period was from April 2009 to March 2010. Specimens were collected from the nose and paranasal sinuses of all clinically and radiologically diagnosed cases of rhinosinusitis. All the clinical specimens were processed by standard methods for fungal culture. This included initial screening by 10% potassium hydroxide, inoculation of the specimen onto Sabouraud dextrose agar and incubation at 25°C and 37°C, followed by slide culture and other special techniques wherever necessary. Histopathological examination was also performed for the specimens. Results: A total of 60 specimens were received for fungal culture from cases of rhinosinusitis during the period, out of which 45 showed no growth. There were nine cases of Aspergillus fl avus, 1 each of Aspergillus fumigatus and Penicillium species. The rest four specimens grew rare fungal isolates, i.e. Acremonium sp., Scedosporium apiospermun, Cladosporium cladosporioides and Lasiodiplodia theobromae. Histopathological fi ndings were also positive for these four cases. Conclusion: Apart from the common causes, unusual fungal pathogens were isolated from cases of rhinosinusitis during the study period, which is in accordance with similar reports from other parts of India and some other countries.

A Case of Cutaneous Scedosporium apiospermum Infection Successfully Treated with Voriconazole / 대한피부과학회지

Scedosporium apiospermum, an asexual state of Pseudallescheria boydii, is a widely distributed mould that can be found in the soil, manure, stagnant water and decaying vegetation. It has become an emerging pathogen among immunosuppressed patients but it can also cause infections in immunocompetent patients by penetrating trauma. This fungus is a classical cause of mycetoma and the localized skin infections caused by this mould are much rarer than mycetoma. We report a case of cutaneous S. apiospermum infection in a 79-year-old woman. She had erythematous plaque with crust and violaceous supprative nodules on the right forearm. The culture from pus showed typical white to gray colored cottony colonies of S. apiospermum. Treatment was started with voriconazole effectively. Skin lesions completely cured with no reccurence. Thus, voriconazole shows to be an effective treatment for Scedosporium infection.

A Case of Fungal Keratitis Scedosporium apiospermum

PURPOSE: To report a case of fungal keratitis caused by Scedosporium apiospermum. CASE SUMMARY: A 70-year-old man visited our clinic with complaints of redness and decreased visual acuity in his right eye caused by a soil gotten into an eye while gardening 10 days ago. The patient had previously been treated in a local clinic but did not show significant clinical improvement. Bacterial and fungal staining, culture, and an antibiotic sensitivity test were performed from a corneal scrape. The cultures revealed growth of Scedosporium apiospermum. The patient was treated with topical moxifloxacin antibiotics, fluconazole, amphotericin B antifungal agents. However, the lesion was not improved, so antifungal therapy was switched to topical voriconazole. After two months of treatment, the infection was resolved with mild scarring. CONCLUSIONS: Although it is a rare pathogen, Scedosporium apiospermum should be considered as a potential pathogen in patients presenting with corneal ulceration due to trauma from an object contaminated by soil, polluted water, or spoiled plant contact. And we suggest that topical application of voriconazole may be a good alternative treatment for patient with fungal keratitis in which no improvement despite a conventional antifungal agent, fluconazole.

El complejo Pseudallescheria/Scedosporium y taxas afines en la rutina del laboratorio micológico clínico / The Pseudallescheria/Scedoporium complex and related taxa in the routine of clinic mycological laboratory

El complejo Pseudallescheria/Scedosporium y taxas relacionados, pertenecientes a un grupo de microhongos con conidios viscosos e integrantes del orden Microascales, se presentan en diversos ambientes comunes asociados a las actividades humanas, ya sea en el suelo como en aguas contaminadas. Actualmente se consideran entre los mayores grupos de hongos filamentosos oportunistas causante de infecciones cutáneas y profundas en el hombre y otros mamíferos. El objetivo principal de este trabajo, consiste en reunir los datos primarios morfofisiológicos más relevantes, útiles para el micólogo médico en el laboratorio, con el aporte adicional de algunos aspectos, biológicos, ecológicos, taxonómicos y moleculares complementarios descritos en la literatura moderna.

The Pseudallescheria/Scedosporium complex and their related taxa are a group of fungus that conidia are presents in viscous mass and belong to the order Microascales. They are in several common enviroment related to human activities either in soil as in contaminated water. Nowadays they are considerated one of the most opportunistic group of filamentous fungus that may cause superficial and deep skin mycoses infections in man and other mammalian. The aim of this work is to gather the primary relevant morphophysiological aspects, usefull to the medical mycologist in the laboratory, plus the contribution of some of biological, ecological, taxonomical and moleculars complementary aspects that are describe in modern literature.