title: Infections caused by Scedosporium spp.
abstract: Scedosporium spp. are increasingly recognized as causes of resistant life-threatening infections in immunocompromised patients. Scedosporium spp. also cause a wide spectrum of conditions, including mycetoma, saprobic involvement and colonization of the airways, sinopulmonary infections, extrapulmonary localized infections, and disseminated infections. Invasive scedosporium infections are also associated with central nervous infection following near-drowning accidents. The most common sites of infection are the lungs, sinuses, bones, joints, eyes, and brain. Scedosporium apiospermum and Scedosporium prolificans are the two principal medically important species of this genus. Pseudallescheria boydii, the teleomorph of S. apiospermum, is recognized by the presence of cleistothecia. Recent advances in molecular taxonomy have advanced the understanding of the genus Scedosporium and have demonstrated a wider range of species than heretofore recognized. Studies of the pathogenesis of and immune response to Scedosporium spp. underscore the importance of innate host defenses in protection against these organisms. Microbiological diagnosis of Scedosporium spp. currently depends upon culture and morphological characterization. Molecular tools for clinical microbiological detection of Scedosporium spp. are currently investigational. Infections caused by S. apiospermum and P. boydii in patients and animals may respond to antifungal triazoles. By comparison, infections caused by S. prolificans seldom respond to medical therapy alone. Surgery and reversal of immunosuppression may be the only effective therapeutic options for infections caused by S. prolificans.
authors.affiliation: Immunocompromised Host Section, Pediatric Oncology Branch, National Cancer Institute, Bethesda, Maryland, USA.
authors.forename: Karoll J
authors.initials: KJ
authors.lastname: Cortez
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Roilides
authors.forename: Flavio
authors.initials: F
authors.lastname: Quiroz-Telles
authors.forename: Joseph
authors.initials: J
authors.lastname: Meletiadis
authors.forename: Charalampos
authors.initials: C
authors.lastname: Antachopoulos
authors.forename: Tena
authors.initials: T
authors.lastname: Knudsen
authors.forename: Wendy
authors.initials: W
authors.lastname: Buchanan
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Milanovich
authors.forename: Deanna A
authors.initials: DA
authors.lastname: Sutton
authors.forename: Annette
authors.initials: A
authors.lastname: Fothergill
authors.forename: Michael G
authors.initials: MG
authors.lastname: Rinaldi
authors.forename: Yvonne R
authors.initials: YR
authors.lastname: Shea
authors.forename: Theoklis
authors.initials: T
authors.lastname: Zaoutis
authors.forename: Shyam
authors.initials: S
authors.lastname: Kottilil
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Walsh
mesh_terms: D000280:Administration, Inhalation; D000818:Animals; D000935:Antifungal Agents / Q000494:pharmacology / Q000627:therapeutic use; D001168:Arthritis / Q000382:microbiology; D044822:Biodiversity; D001850:Bone Diseases, Infectious / Q000382:microbiology; D020314:Central Nervous System Fungal Infections / Q000382:microbiology; D015821:Eye Infections, Fungal / Q000382:microbiology; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008826:Microbial Sensitivity Tests; D008271:Mycetoma / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology / Q000628:therapy; D010802:Phylogeny; D012141:Respiratory Tract Infections / Q000382:microbiology; D021681:Scedosporium / Q000145:classification / Q000187:drug effects / Q000472:pathogenicity / Q000502:physiology
chemical_list: D000935:Antifungal Agents; D007166:Immunosuppressive Agents