title: [Scedosporium apiospermum disseminated infection in a single lung transplant recipient].
abstract: BACKGROUND
  Scedosporium spp. are filamentous fungi, and the 2 most important species are Scedosporium prolificans and Scedosporium apiospermum. S. apiospermum accounts for approximately 25% of non-Aspergillus filamentous fungi infections in organ transplant recipients. Scedosporium can colonize the sinuses and airways of lung recipients with underlying pulmonary diseases, such as bronchiectasis or cystic fibrosis before transplant, and develop invasive disease after lung transplantation. In fact, invasive diseases caused by S. apiospermum have been reported only rarely, in single lung transplant recipients and cystic fibrosis transplant patients. The treatment of scedosporiasis is complicated due to the difficulty in early diagnosis together with inherent resistance to amphotericin B.
  
  
  METHODS
  A case of disseminated S. apiospermum infection after single lung transplant in a patient with pulmonary fibrosis is reported. Leg mycetoma was the initial sign of this disseminated infection. In this case report, current treatment options are discussed, and a review of the literature of previously published cases of lung transplants is made.
  
  
  CONCLUSIONS
  One conclusion based on this case is the risk of emergent molds related to antifungal prophylaxis. In addition, colonization by Scedosporium in transplant recipients should not be ignored, and target prophylaxis or suppressive therapy should be considered in all those cases with residual lesions in native lung or chronic rejection in transplanted lungs.
authors.affiliation: Unidad de Trasplante Pulmonary Fibrosis Quística, Hospital Universitario la Fe, Valencia, España. sole_amp@gva.es
authors.forename: Amparo
authors.initials: A
authors.lastname: Solé
mesh_terms: D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D002177:Candidiasis / Q000188:drug therapy / Q000209:etiology / Q000382:microbiology; D003131:Combined Modality Therapy; D003428:Cross Infection / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology / Q000601:surgery; D003646:Debridement; D003840:Deoxycholic Acid / Q000627:therapeutic use; D004338:Drug Combinations; D017809:Fatal Outcome; D016469:Fungemia / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology; D006084:Graft Rejection / Q000188:drug therapy; D006801:Humans; D054990:Idiopathic Pulmonary Fibrosis / Q000188:drug therapy / Q000601:surgery; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D017964:Itraconazole / Q000627:therapeutic use; D007654:Ketoconazole / Q000627:therapeutic use; D016040:Lung Transplantation; D008297:Male; D008875:Middle Aged; D008271:Mycetoma / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology / Q000601:surgery; D009894:Opportunistic Infections / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology / Q000601:surgery; D011183:Postoperative Complications / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology / Q000601:surgery; D021681:Scedosporium / Q000302:isolation & purification*
chemical_list: D000935:Antifungal Agents; D004338:Drug Combinations; D007166:Immunosuppressive Agents; D003840:Deoxycholic Acid; D017964:Itraconazole; D000666:Amphotericin B; C059765:amphotericin B, deoxycholate drug combination; D007654:Ketoconazole