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Management of pulmonary Scedosporium apiospermum infection by thoracoscopic surgery in an immunocompetent woman
The Scedosporium apiospermum complex is a group of emerging opportunistic fungal pathogens that affect both immunocompromised and immunocompetent individuals, most commonly via lung infection. Although they are resistant to many antifungal agents, this group of pathogens has a favorable susceptibili...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7333505/ https://www.ncbi.nlm.nih.gov/pubmed/32614267 http://dx.doi.org/10.1177/0300060520931620 |
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author | Liu, Wei Feng, Ruizhi Jiang, Hongli |
author_facet | Liu, Wei Feng, Ruizhi Jiang, Hongli |
author_sort | Liu, Wei |
collection | PubMed |
description | The Scedosporium apiospermum complex is a group of emerging opportunistic fungal pathogens that affect both immunocompromised and immunocompetent individuals, most commonly via lung infection. Although they are resistant to many antifungal agents, this group of pathogens has a favorable susceptibility profile to azoles, especially voriconazole. Here, we describe the management of S. apiospermum infection in an otherwise healthy 44-year-old woman. She had exhibited intermittent hemoptysis for 2 years before admission to our hospital. Computed tomography revealed a thin-walled and well-circumscribed cavitary lesion in the left upper lobe; the lesion was filled with consolidative opacities. Fungal culture of bronchoalveolar lavage fluid specimens revealed grayish-white mold; lactophenol cotton blue staining revealed acute angle branched septate hyaline cylindrical hyphae, characteristic of S. apiospermum. Despite voriconazole 200 mg twice daily for 8 weeks, the patient showed no improvement; thus, her left upper lobe was removed via thoracoscopic surgery. Her symptoms immediately improved and chest radiography after surgical resection showed no evidence of radiological progression or reoccurrence. This report demonstrates that S. apiospermum lung infection may not respond well to voriconazole alone in immunocompetent hosts; thus, surgery could be curative for these patients. |
format | Online Article Text |
id | pubmed-7333505 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-73335052020-07-10 Management of pulmonary Scedosporium apiospermum infection by thoracoscopic surgery in an immunocompetent woman Liu, Wei Feng, Ruizhi Jiang, Hongli J Int Med Res Case Report The Scedosporium apiospermum complex is a group of emerging opportunistic fungal pathogens that affect both immunocompromised and immunocompetent individuals, most commonly via lung infection. Although they are resistant to many antifungal agents, this group of pathogens has a favorable susceptibility profile to azoles, especially voriconazole. Here, we describe the management of S. apiospermum infection in an otherwise healthy 44-year-old woman. She had exhibited intermittent hemoptysis for 2 years before admission to our hospital. Computed tomography revealed a thin-walled and well-circumscribed cavitary lesion in the left upper lobe; the lesion was filled with consolidative opacities. Fungal culture of bronchoalveolar lavage fluid specimens revealed grayish-white mold; lactophenol cotton blue staining revealed acute angle branched septate hyaline cylindrical hyphae, characteristic of S. apiospermum. Despite voriconazole 200 mg twice daily for 8 weeks, the patient showed no improvement; thus, her left upper lobe was removed via thoracoscopic surgery. Her symptoms immediately improved and chest radiography after surgical resection showed no evidence of radiological progression or reoccurrence. This report demonstrates that S. apiospermum lung infection may not respond well to voriconazole alone in immunocompetent hosts; thus, surgery could be curative for these patients. SAGE Publications 2020-07-02 /pmc/articles/PMC7333505/ /pubmed/32614267 http://dx.doi.org/10.1177/0300060520931620 Text en © The Author(s) 2020 https://creativecommons.org/licenses/by-nc/4.0/ Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Case Report Liu, Wei Feng, Ruizhi Jiang, Hongli Management of pulmonary Scedosporium apiospermum infection by thoracoscopic surgery in an immunocompetent woman |
title | Management of pulmonary Scedosporium apiospermum infection by thoracoscopic surgery in an immunocompetent woman |
title_full | Management of pulmonary Scedosporium apiospermum infection by thoracoscopic surgery in an immunocompetent woman |
title_fullStr | Management of pulmonary Scedosporium apiospermum infection by thoracoscopic surgery in an immunocompetent woman |
title_full_unstemmed | Management of pulmonary Scedosporium apiospermum infection by thoracoscopic surgery in an immunocompetent woman |
title_short | Management of pulmonary Scedosporium apiospermum infection by thoracoscopic surgery in an immunocompetent woman |
title_sort | management of pulmonary scedosporium apiospermum infection by thoracoscopic surgery in an immunocompetent woman |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7333505/ https://www.ncbi.nlm.nih.gov/pubmed/32614267 http://dx.doi.org/10.1177/0300060520931620 |
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