Scedosporium prolificans fungaemia in a patient with acute lymphoblastic leukaemia

J Mycol Med. 2013 Dec;23(4):261-4. doi: 10.1016/j.mycmed.2013.08.003. Epub 2013 Oct 14.

Abstract

Aggressive chemotherapy and immunosuppressive treatment may prolong patients' life, but influence the risk of severe, life-threatening infections. Here, we report the case of a 21-year-old caucasian female who developed a disseminated infection of Scedosporium prolificans after allogenic stem cell transplantation performed for treatment of relapsed acute lymphoblastic leukaemia. The pathogen was isolated from the blood and identified on the basis of its macroscopic and microscopic morphological features. The empirical treatment with amphotericin B provided no improvement. However, introduction of intravenous voriconazole resulted in amelioration of fever. Unfortunately, the patient died due to progression of underlying disease and multiorgan failure. However, this case report indicates a possible relevance of voriconazole-based treatment regimens in invasive S. prolificans infections.

Keywords: Acute leukaemia; Disseminated fungal infection; Immunocompromised patient; Immunodépression; Infection fongique disséminée; Leucémie aiguë; Scedosporium prolificans; Voriconazole.

Publication types

  • Case Reports

MeSH terms

  • Allografts
  • Amphotericin B / therapeutic use
  • Antifungal Agents / therapeutic use
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Bone Marrow Transplantation
  • Drug Substitution
  • Fatal Outcome
  • Female
  • Fluconazole / administration & dosage
  • Fluconazole / therapeutic use
  • Fungemia / drug therapy
  • Fungemia / etiology*
  • Fungemia / microbiology
  • Graft vs Host Disease / drug therapy
  • Humans
  • Immunocompromised Host
  • Immunosuppressive Agents / adverse effects
  • Immunosuppressive Agents / therapeutic use
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / complications*
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / drug therapy
  • Recurrence
  • Scedosporium / isolation & purification*
  • Triazoles / administration & dosage
  • Triazoles / therapeutic use
  • Voriconazole / therapeutic use
  • Young Adult

Substances

  • Antifungal Agents
  • Immunosuppressive Agents
  • Triazoles
  • posaconazole
  • Amphotericin B
  • Fluconazole
  • Voriconazole