Recurrent Scedosporium apiospermum mycetoma successfully treated by surgical excision and terbinafine treatment: A case report and review of the literature

Eszter J. Tóth, Géza R. Nagy, Mónika Homa, Marianna Ábrók, Ildikó Kiss, Gábor Nagy, Zsuzsanna Bata-Csörgo, Lajos Kemény, Edit Urbán, Csaba Vágvölgyi, Tamás Papp

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background: Scedosporium apiospermum is an emerging opportunistic filamentous fungus, which is notorious for its high levels of antifungal-resistance. It is able to cause localized cutaneous or subcutaneous infections in both immunocompromised and immunocompetent persons, pulmonary infections in patients with predisposing pulmonary diseases and invasive mycoses in immunocompromised patients. Subcutaneous infections caused by this fungus frequently show chronic mycetomatous manifestation. Case report: We report the case of a 70-year-old immunocompromised man, who developed a fungal mycetomatous infection on his right leg. There was no history of trauma; the aetiological agent was identified by microscopic examination and ITS sequencing. This is the second reported case of S. apiospermum subcutaneous infections in Hungary, which was successfully treated by surgical excision and terbinafine treatment. After 7 months, the patient remained asymptomatic. Considering the antifungal susceptibility and increasing incidence of the fungus, Scedosporium related subcutaneous infections reported in the past quarter of century in European countries were also reviewed. Conclusions: Corticosteroid treatment represents a serious risk factor of S. apiospermum infections, especially if the patient get in touch with manure-enriched or polluted soil or water. Such infections have emerged several times in European countries in the past decades. The presented data suggest that besides the commonly applied voriconazole, terbinafine may be an alternative for the therapy of mycetomatous Scedosporium infections.

Original languageEnglish
Article number31
JournalAnnals of Clinical Microbiology and Antimicrobials
Volume16
Issue number1
DOIs
Publication statusPublished - Apr 14 2017

Keywords

  • Antifungal susceptibility
  • Corticosteroid therapy
  • Cutaneous infection
  • Filamentous fungi
  • Immunosuppression
  • Scedosporium apiospermum

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

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