Disseminated Scedosporium apiospermum infection in a previously healthy woman with HELLP syndrome.
A previously healthy 33-year-old female died of disseminated infection with Scedosporium apiospermum in association with Hemolysis, Elevated Liver enzymes, and Low Platelets (HELLP) syndrome following the delivery of twins. Her postpartum course was complicated by multisystem organ failure managed with extracorporeal membrane oxygenation (ECMO). She also developed bowel and left lower extremity ischemia requiring surgical resection. Blood cultures yielded S. apiospermum, and histologic findings revealed in vivo adventitious sporulation, an unusual occurrence with this pathogen. Autopsy showed extensive fungal infection of brain, lungs, thyroid, heart, and kidneys.
Riddell
J
J
Division of Infectious Diseases, Department of Internal Medicine, Veterans Affairs Ann Arbor Healthcare System and University of Michigan Medical School, Ann Arbor, MI, USA.
Chenoweth
C E
CE
Kauffman
C A
CA
D000328:Adult; D005260:Female; D017359:HELLP Syndrome / Q000150:complications* / Q000453:epidemiology* / Q000401:mortality; D006801:Humans; D008428:Maternal Mortality; D009102:Multiple Organ Failure / Q000209:etiology; D008271:Mycetoma / Q000150:complications / Q000175:diagnosis / Q000635:transmission*; D049590:Postpartum Period; D011247:Pregnancy; D021681:Scedosporium / Q000302:isolation & purification*