title: An unusual pathogen in ambulatory care: two cases of Scedosporium soft tissue infections presenting as "unresponsive cellulitis".
abstract: Soft tissue infections with Scedosporium spp. are an uncommon but serious and emerging cause of infection in immunocompromised patients. Acute Medical Units (AMUs) in the UK are increasingly managing patients with cellulitis in an outpatient setting, therefore acute physicians should be aware of some of the more uncommon causes of soft tissue infection, particularly in patients not responding to initial antibiotic therapy. We present two cases of Scedosporium presenting to the AMU as cellulitis not responding to initial antibiotic therapy and outline the assessment and management of this important condition.
authors.affiliation: MBBS, MRCP (UK), PgDip (Med Tox), ST4 Acute and General Internal Medicine and Intensive Care Medicine, Hampshire Hospitals NHS Foundation Trust.
authors.forename: Gary Peter
authors.initials: GP
authors.lastname: Misselbrook
authors.affiliation: MB ChB, MRCP, DTM&H, PhD, Consultant in Acute Medicine and Infectious Diseases, University Hospitals Southampton NHS Foundation Trust.
authors.forename: Patrick
authors.initials: P
authors.lastname: Lillie
authors.affiliation: MRCP, FRCPath, DPhil OXON, Consultant in Microbiology and Infectious Diseases, Hampshire Hospitals NHS Foundation Trust.
authors.forename: Claire P
authors.initials: CP
authors.lastname: Thomas
mesh_terms: D000328:Adult; D000553:Ambulatory Care / Q000379:methods; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D000935:Antifungal Agents / Q000008:administration & dosage*; D002481:Cellulitis / Q000175:diagnosis*; D057915:Drug Substitution / Q000379:methods; D004632:Emergency Medical Services / Q000379:methods; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D009181:Mycoses / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology / Q000503:physiopathology; D021681:Scedosporium / Q000187:drug effects / Q000302:isolation & purification; D018461:Soft Tissue Infections / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology / Q000503:physiopathology; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D000935:Antifungal Agents