Scedosporium species and Lomentospora prolificans fungaemia is uniformly fatal in patients with haematological malignancy

Intern Med J. 2023 Aug;53(8):1489-1491. doi: 10.1111/imj.16198.

Abstract

Scedosporium and Lomentospora species are environmental moulds that are virulent in immunocompromised hosts and rarely cause bloodstream infection (BSI). Patients with Scedosporium and Lomentospora species BSI were identified by the state public laboratory service in Queensland, Australia, over a 20-year period. Twenty-two incident episodes occurred among 21 residents; one patient had a second episode 321 days following the first. Of these, 18 were Lomentospora prolificans, three were Scedosporium apiospermum complex and one was a nonspeciated Scedosporium species. Seventeen (81%) patients died during their index admission, and all-cause mortality at 30, 90 and 365 days was 73%, 82% and 91% respectively. All 20 patients with haematological malignancy died within 365 days of follow-up with a median time to death of 9 days (interquartile range, 6-20 days) following diagnoses of BSI.

Keywords: Lomentospora; fungaemia; invasive fungal disease; leukaemia; lymphoma.

MeSH terms

  • Adult
  • Australia / epidemiology
  • Female
  • Fungemia* / diagnosis
  • Fungemia* / epidemiology
  • Fungemia* / microbiology
  • Fungemia* / mortality
  • Humans
  • Immunocompromised Host*
  • Leukemia* / epidemiology
  • Leukemia* / mortality
  • Male
  • Middle Aged
  • Scedosporium* / isolation & purification
  • Scedosporium* / pathogenicity