Journal Article

Invasive Pulmonary Infection Due to <i>Scedosporium apiospermum</i> in Two Children with Chronic Granulomatous Disease

Nada Jabado, Jean-Laurent Casanova, Elie Haddad, Fabienne Dulieu, Jean-Christophe Fournet, Bertrand Dupont, Alain Fischer, Christophe Hennequin and Stéphane Blanche

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 27, issue 6, pages 1437-1441
Published in print December 1998 | ISSN: 1058-4838
Published online December 1998 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/515015
Invasive Pulmonary Infection Due to Scedosporium apiospermum in Two Children with Chronic Granulomatous Disease

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Scedosporium apiospermum is an opportunistic fungus in humans. The incidence of S. apiospermum infection in patients with acquired neutropenia (e.g., patients receiving chemotherapy and bone marrow transplant recipients) is steadily increasing. S. apiospermum has poor in vitro susceptibility to “conventional” antifungal agents, rendering the management of infections complex. Patients with chronic granulomatous disease (CGD) are highly susceptible to fungal infections, which are mostly due to Aspergillus species. We describe two children with CGD and invasive pulmonary infection due to S. apiospermum. Both patients were treated with antifungal therapy including azole derivatives (itraconazole or voriconazole) and surgical resection of infected tissues. These cases highlight that scedosporium infection can closely mimic aspergillus infection and should be considered in any case in which there is a failure to respond to appropriate “conventional” antifungal therapy. We also suggest that the emergence of this pathogen may have been favored by long-term use of amphotericin B in both patients.

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Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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