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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...

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Autores principales: Liu, Wei, Feng, Ruizhi, Jiang, Hongli
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2020
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.
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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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