title: Scedosporium apiospermum causing brain abscess in a renal allograft recipient.
abstract: Scedosporium apiospermum is the asexual form of a rare fungus Pseudallescheria boydii that is usually present in the soil, sewage and dirty water. In immunocompromised patients, it is a rare infection involving multiple organs. We present a case of renal allograft recipient who developed fever two weeks post renal transplant. He was initially found to have dengue fever. After five days, he became drowsy and developed right-sided hemiparesis. Magnetic resonance imaging of the brain revealed multiple irregular masses with associated edema consistent with fungal brain abscesses. Left parietal abscess was drained and he was started on voriconazole. His cyclosporine was stopped. Drained pus revealed fungal hyphae on potassium hydroxide stain and Scedosporium apiospermum on culture. Unfortunately, the patient died after five days. Scedosporium infections should be kept as a possibility in transplant recipients with disseminated infections, especially with a brain abscess. Despite antifungal therapy and surgical drainage, mortality rates are high.
authors.affiliation: Department of Nephrology, Institute of Renal Sciences, Sir Ganga Ram Hospital, New Delhi, India.
authors.forename: Amit
authors.initials: A
authors.lastname: Sharma
authors.forename: Divya
authors.initials: D
authors.lastname: Singh
mesh_terms: D000328:Adult; D000935:Antifungal Agents / Q000627:therapeutic use; D001922:Brain Abscess / Q000188:drug therapy / Q000382:microbiology* / Q000601:surgery; D003131:Combined Modality Therapy; D004322:Drainage; D017809:Fatal Outcome; D006801:Humans; D016030:Kidney Transplantation; D008279:Magnetic Resonance Imaging; D008297:Male; D009181:Mycoses / Q000150:complications*; D011184:Postoperative Period; D021681:Scedosporium; D066027:Transplant Recipients; D065819:Voriconazole / Q000627:therapeutic use
chemical_list: D000935:Antifungal Agents; D065819:Voriconazole