[Scedosporium apiospermum infection in a kidney transplant recipient]. / Infección por Scedosporium apiospermum en una paciente con trasplante renal.

BACKGROUND: Emerging fungi infections, although being not the most frequent, are a cause of major morbidity and mortality in recipients of solid organ transplants. The infections caused by the fungi Scedosporium apiospermum are a paradigmatic example of these. CASE REPORT: We present the clinical case of a 55 year-old female kidney transplant recipient that got infected with S. apiospermum through the skin. Intensive antifungal therapy was started, especially considering that the patient had an arteriovenous fistula at the site of infection. The fungus could have kept in the fistula, and a subsequent reinfection took place. The patient required both medical and surgical treatment (removal of the prosthetic material), that led to a complete recovery. CONCLUSIONS: S. apiospermum infections carry a high risk of complications, and are a frequent cause of morbidity and mortality in immunosuppressed/transplant patients. Therefore, the adequate knowledge of this type of mycosis, as well as the making of an adequate differential diagnosis, become fundamental for the prevention of the complications arising from them.

Infección por Scedosporium apiospermum en una paciente con trasplante renal / Scedosporium apiospermum infection in a kidney transplant recipient

Antecedentes: Las infecciones por hongos emergentes, si bien no son las más frecuentes, son causantes de una importante morbimortalidad en receptores de trasplante de órgano sólido. Las infecciones por el hongo Scedosporium apiospermum suponen un ejemplo paradigmático de las mismas. Caso clínico: Se presenta el caso clínico de una paciente trasplantada renal de 55 años, que a través de la piel sufre una infección por S. apiospermum. Se comenzó una terapia antifúngica intensiva ya que la paciente, además, era portadora de una fístula arteriovenosa en la zona de entrada de la infección. El hongo pudo quedar acantonado y la paciente sufrió una reinfección que requirió tratamiento de nuevo, tanto médico como quirúrgico (retirada del material protésico), que llevó a la curación de la paciente. Conclusiones: Las infecciones por S. apiospermum conllevan un alto riesgo de complicaciones y son una causa frecuente de morbimortalidad en el paciente inmunodeprimido/trasplantado. Por ello, el adecuado conocimiento de este tipo de micosis, así como la realización de un adecuado diagnóstico diferencial, se tornan fundamentales para la prevención de las complicaciones derivadas de las mismas

Background: Emerging fungi infections, although being not the most frequent, are a cause of major morbidity and mortality in recipients of solid organ transplants. The infections caused by the fungi Scedosporium apiospermum are a paradigmatic example of these. Case report: We present the clinical case of a 55 year-old female kidney transplant recipient that got infected with S. apiospermum through the skin. Intensive antifungal therapy was started, especially considering that the patient had an arteriovenous fistula at the site of infection. The fungus could have kept in the fistula, and a subsequent reinfection took place. The patient required both medical and surgical treatment (removal of the prosthetic material), that led to a complete recovery. Conclusions: S. apiospermum infections carry a high risk of complications, and are a frequent cause of morbidity and mortality in immunosuppressed/transplant patients. Therefore, the adequate knowledge of this type of mycosis, as well as the making of an adequate differential diagnosis, become fundamental for the prevention of the complications arising from them