Journal Article

A systemic infection involved in lung, brain and spine caused by Scedosporium apiospermum species complex after near-drowning: a case report and literature review

Yan, Peng, Chen, Junfeng, Mo, Guoxin, Wang, Haodi, Jia, Qi, Xie, Jungang

2024

Overview

Scedosporium apiospermum species complex are widely distributed fungi that can be found in a variety of polluted environments, including soil, sewage, and decaying vegetation. Those opportunistic pathogens with strong potential of invasion commonly affect immunosuppressed populations However, few cases of scedosporiosis are reported in immunocompetent individuals, who might be misdiagnosed, leading to a high mortality rate. Here, we reported an immunocompetent case of systemtic infection involved in lung, brain and spine, caused by S. apiospermum species complex ( S. apiospermum and S. boydii ). The patient was an elderly male with persistent fever and systemtic infection after near-drowning. In the two tertiary hospitals he visited, definite diagnosis was extremely difficult. After being admitted to our hospital, he was misdiagnosed as tuberculosis infection, before diagnosis of S. apiospermum species complex infection by the metagenomic next-generation sequencing. His symptoms were alleviated after voriconazole treatment. In the present case, the details associated with its course were reported and published studies on Scedosporium spp. infection were also reviewed, for a better understanding of this disease and reducing the misdiagnosis rate.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Antifungal agents / Blood / Body temperature / Bone marrow / Brain / Case Report / Case reports / Caspofungin / Causes of / Diagnosis / Diagnostic tests / Disseminated infection / Drowning / Drug therapy / Fever / Health aspects / Hemoptysis / Herpes viruses / Hospitals / Immunocompetence / Infection / Infections / Infectious Diseases / Internal Medicine / Literature reviews / Lungs / Magnetic resonance imaging / Medical Microbiology / Medical research / Medicine / Medicine & Public Health / Medicine, Experimental / Metagenomic next-generation sequencing / Metagenomics / Mortality / Mycoses / Near drowning / Next-generation sequencing / Opportunist infection / Parasitology / Pathogens / Patient outcomes / Polluted environments / Proteins / Rifapentine / Scedosporium apiospermum / Scedosporium apiospermum species complex / Sewage / Signs and symptoms / Soil pollution / Spine / Sulbactam / Systemtic infection / Tomography / Tropical Medicine / Tuberculosis / Voriconazole