title: Cerebral Scedosporium apiospermum infection presenting with intestinal manifestations.
abstract: We present a case of cerebral Scedosporium apiospermum infection presenting with intestinal manifestations in a 64-year-old male patient on immunosuppression for orthotopic liver transplantation. At admission, the patient's chief complaint was chronic watery diarrhea and he was found to have colonic ulcers on endoscopy. His hospital course was complicated by a tonic-clonic seizure caused by a left frontal brain abscess, with the causative agent being identified by culture. He was treated with lobectomy, high-dose intravenous voriconazole, and liposomal amphotericin with clinical, endoscopic, and histologic improvement. To our knowledge, S. apiospermum has not been previously described as a cause of colitis. The septate branching appearance of the Scedosporium species is similar to the more common Aspergillus species. This case of gastrointestinal Scedosporium brings into question previously reported cases of isolated gastrointestinal aspergillosis diagnosed by histopathology. Clinical suspicion for S. apiospermum must be maintained in immunosuppressed patients presenting with neurologic and gastrointestinal symptoms.
authors: Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA. derekl@bcm.edu
authors: D
authors: D
authors: Lin
authors: Q
authors: Q
authors: Kamili
authors: K
authors: K
authors: Qurat-Ul-Ain
authors: S
authors: S
authors: Lai
authors: D M
authors: DM
authors: Musher
authors: R
authors: R
authors: Hamill
mesh_terms: D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D001922:Brain Abscess / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology / Q000601:surgery; D020314:Central Nervous System Fungal Infections / Q000150:complications* / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology; D003093:Colitis, Ulcerative / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D006651:Histocytochemistry; D006801:Humans; D008297:Male; D008853:Microscopy; D008875:Middle Aged; D011612:Psychosurgery; D011743:Pyrimidines / Q000627:therapeutic use; D021681:Scedosporium / Q000302:isolation & purification*; D014230:Triazoles / Q000627:therapeutic use; D065819:Voriconazole
chemical_list: D000935:Antifungal Agents; D011743:Pyrimidines; D014230:Triazoles; C068538:liposomal amphotericin B; D000666:Amphotericin B; D065819:Voriconazole