Scedosporium infection disseminated "from toe to head" in allogeneic stem cell transplant recipient: a case report

BMC Infect Dis. 2023 May 25;23(1):353. doi: 10.1186/s12879-023-08345-2.

Abstract

Background: Scedosporium is a lesser-known non-Aspergillus genus of mold that can present in unsuspecting ways. If overlooked, it may disseminate and cause high mortality in high-risk allogeneic stem cell transplant recipients.

Case presentation: This case report describes a 65-year-old patient with Acute Myeloid Leukemia who underwent an allogeneic hematopoietic stem cell transplant after a period of prolonged neutropenia with fluconazole prophylaxis. She suffered severe debility with altered mentation from a S. apiospermum infection which likely disseminated from a toe wound to the lung and central nervous system. She was successfully treated with liposomal amphotericin B and voriconazole, but faced a prolonged recovery from physical and neurologic sequela.

Conclusions: The case highlights the importance of adequate anti-mold prophylaxis in high-risk patients, and the value of a thorough physical examination in this patient population, with particular attention to skin and soft tissue findings.

Keywords: Allogeneic transplant; Case report; Invasive fungal disease; Scedosporium.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Antifungal Agents / therapeutic use
  • Female
  • Hematopoietic Stem Cell Transplantation* / adverse effects
  • Humans
  • Scedosporium*
  • Toes
  • Voriconazole / therapeutic use

Substances

  • Antifungal Agents
  • Voriconazole

Supplementary concepts

  • scedosporiosis