title: Scedosporium apiospermum skeletal infection in an immunocompetent child.
abstract: Abstract This is a case of Scedosporium apiospermum skeletal infection in a 10-year-old immunocompetent girl whose chief complaint was left knee swelling and pain. The child had a history of a bicycle accident two months before with a resultant deep penetrating trauma. Systematic administration of broad-spectrum antibiotics for 10 days was used, with no clinical improvement. Magnetic Resonance Imaging and arthrotomy of the affected joint revealed findings suggestive of osteomyelitis. Empirical intravenous antimicrobial therapy was instituted for a total of two months but one month after completion of antibacterial therapy the child returned to the hospital because of persistent knee swelling and pain. Following a new arthrotomy, Scedosporium apiospermum was isolated. The patient was cured with intravenous administration of voriconazole without any side effects and has no evidence of relapse after four years of follow-up.
authors.affiliation: Second Department of Pediatrics, P. and A. Kyriakou Children's Hospital, Thivon & Levadias Street, Athens, Greece. stripeli@med.uoa.gr
authors.forename: Fotini
authors.initials: F
authors.lastname: Stripeli
authors.forename: D
authors.initials: D
authors.lastname: Pasparakis
authors.forename: Aristea
authors.initials: A
authors.lastname: Velegraki
authors.forename: E
authors.initials: E
authors.lastname: Lebessi
authors.forename: G
authors.initials: G
authors.lastname: Arsenis
authors.forename: D
authors.initials: D
authors.lastname: Kafetzis
authors.forename: M
authors.initials: M
authors.lastname: Tsolia
mesh_terms: D000935:Antifungal Agents / Q000627:therapeutic use; D002648:Child; D005260:Female; D006801:Humans; D007717:Knee / Q000000981:diagnostic imaging; D009181:Mycoses / Q000175:diagnosis* / Q000188:drug therapy / Q000601:surgery; D010019:Osteomyelitis / Q000188:drug therapy / Q000382:microbiology* / Q000601:surgery; D011743:Pyrimidines / Q000627:therapeutic use; D011859:Radiography; D021681:Scedosporium / Q000302:isolation & purification*; D014230:Triazoles / Q000627:therapeutic use; D065819:Voriconazole
chemical_list: D000935:Antifungal Agents; D011743:Pyrimidines; D014230:Triazoles; D065819:Voriconazole