Treatment of a brain abscess caused by Scedosporium apiospermum and Phaeoacremonium parasiticum in a renal transplant recipient.
Cerebral mycosis is a significant cause of morbidity among immunocompromised populations. We present here a case of cerebral infection with Scedosporium apiospermum and Phaeoacremonium parasiticum in a 49-year-old renal transplant recipient. Fourteen years after renal transplantation, the patient presented with invasive pulmonary aspergillosis treated with intravenous liposomal amphotericin B. The patient had clinical and radiographic improvement. However, 6 weeks later, the patient presented with cerebral infection. Magnetic resonance imaging revealed multiple rim enhancing brain abscesses. Brain and cerebrospinal fluid cultures ultimately grew Scedosporium apiospermum and Phaeoacremonium parasiticum. The patient was treated with voriconazole for 6 months and had clinical and radiologic improvement. We believe this is the first reported case of co-infection of the brain with scedosporiosis and phaeohyphomycosis in a renal transplant recipient, who had received intravenous liposomal amphotericin B. Voriconazole may represent a new therapeutic option for these simultaneous infections in the brain.
Division of Anatomical Pathology, Faculty of Medicine Ramathibodi Hospital Mahidol University, Bangkok, Thailand. Noppadol_l@hotmail.com
Noppadol
N
Larbcharoensub
Piriyaporn
P
Chongtrakool
Chewarat
C
Wirojtananugoon
Siriorn P
SP
Watcharananan
Vasant
V
Sumethkul
Atthaporn
A
Boongird
Sopon
S
Jirasiritham
D000935:Antifungal Agents / Q000627:therapeutic use; D001922:Brain Abscess / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D060425:Cerebral Phaeohyphomycosis / Q000175:diagnosis / Q000188:drug therapy; D060085:Coinfection / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D006801:Humans; D016867:Immunocompromised Host; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000175:diagnosis* / Q000188:drug therapy; D011743:Pyrimidines / Q000627:therapeutic use; D021681:Scedosporium; D014230:Triazoles / Q000627:therapeutic use; D065819:Voriconazole
D000935:Antifungal Agents; D011743:Pyrimidines; D014230:Triazoles; D065819:Voriconazole