Dermatic Scedosporium apiospermum infection after autologous bone marrow transplantation

Intern Med. 2013;52(6):689-93. doi: 10.2169/internalmedicine.52.8532. Epub 2013 Mar 15.

Abstract

Infection with Scedosporium apiospermum (S. apiospermum) is rare, although it is associated with a high fatality rate, especially in immunosuppressed patients. A 23-year-old man with acute myelogenous leukemia (AML) (M2) who was pretreated with chemotherapy for autologous bone marrow transplantation developed a skin ulcer on the left groin. After a culture study demonstrated the presence of S. apiospermum, voriconazole was administered and the lesion rapidly improved. Since a diagnosis of S. apiospermum continues to depend on the results of a fungal culture and most isolates of S. apiospermum are resistant to amphotericin B, voriconazole should be considered as the first choice when "mold" is thought to be the causative organism.

Publication types

  • Case Reports

MeSH terms

  • Antifungal Agents / therapeutic use
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects*
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Bone Marrow Transplantation*
  • Combined Modality Therapy
  • Cytarabine / administration & dosage
  • Daunorubicin / administration & dosage
  • Dermatomycoses / drug therapy
  • Dermatomycoses / etiology*
  • Dermatomycoses / microbiology
  • Drugs, Chinese Herbal / therapeutic use
  • Humans
  • Immunocompromised Host
  • Immunosuppressive Agents / adverse effects*
  • Leukemia, Myeloid, Acute / drug therapy
  • Leukemia, Myeloid, Acute / surgery
  • Male
  • Mitoxantrone / administration & dosage
  • Opportunistic Infections / drug therapy
  • Opportunistic Infections / etiology*
  • Opportunistic Infections / microbiology
  • Postoperative Complications / drug therapy
  • Postoperative Complications / microbiology*
  • Pyrimidines / therapeutic use
  • Scedosporium / isolation & purification*
  • Skin Ulcer / drug therapy
  • Skin Ulcer / etiology*
  • Skin Ulcer / microbiology
  • Transplantation Conditioning
  • Transplantation, Autologous
  • Triazoles / therapeutic use
  • Voriconazole
  • Young Adult

Substances

  • Antifungal Agents
  • Drugs, Chinese Herbal
  • Immunosuppressive Agents
  • Pyrimidines
  • Triazoles
  • ru-yi-jin-huang-san
  • Cytarabine
  • Mitoxantrone
  • Voriconazole
  • Daunorubicin