No abstract available.
Humans ; Intracranial Aneurysm* ; Multiple Sclerosis* ; Scedosporium*

No abstract available.
Cellulitis* ; Scedosporium*

This study analyzed the recent causes, prognosis, and treatment strategies for fungal endophthalmitis. A retrospective review of patients who were diagnosed with fungal endophthalmitis at our center was conducted. The fungal organisms isolated from each patient and the visual prognosis according to the route of infection and treatment method were analyzed. A total of 40 eyes from 30 patients with fungal endophthalmitis were included in this study. Candida species were the most common causative organisms in 35 of 40 eyes. Endogenous and exogenous endophthalmitis were observed in 33 and 7 eyes, respectively. Pre- and post-treatment best-corrected visual acuity (BCVA) was not significantly different between endogenous endophthalmitis and exogenous endophthalmitis. The 40 eyes were treated using the following modalities: intravitreal antifungal agent injection with intravenous antifungal agent (16 eyes), vitrectomy with intravenous antifungal agent (14 eyes), intravenous antifungal agent alone (9 eyes), and evisceration (1 eye). Post-treatment BCVA only significantly improved after treatment in the vitrectomy group. Candida species were the most common cause of fungal endophthalmitis, irrespective of the route of infection. The visual prognosis of fungal endophthalmitis was generally poor. In conclusion, if the general condition of the patient tolerates a surgical procedure, prompt vitrectomy and intravitreal injection of antifungal agents can improve visual acuity.
Antifungal Agents/*therapeutic use ; Aspergillus/isolation & purification ; Candida/*isolation & purification ; Endophthalmitis/*drug therapy/*microbiology/pathology/surgery ; Eye Infections, Fungal ; Fusarium/isolation & purification ; Humans ; Prognosis ; Republic of Korea ; Retrospective Studies ; Scedosporium/isolation & purification ; Tertiary Care Centers ; Visual Acuity ; *Vitrectomy

Antifungal Agents ; therapeutic use ; Humans ; Male ; Mycoses ; diagnosis ; drug therapy ; Near Drowning ; microbiology ; Scedosporium ; pathogenicity

Scedosporium apiospermum is an asexual state of Pseudallescheria boydii which has been isolated from soil, sewage, and decaying vegetation. It can cause cutaneous infections by traumatic implantation of the contaminant due to penetrating injury. This ubiquitous fungus cause not only mycetoma, but also infections of variety of body sites including the skin. The localized skin infection due to this organism is much rare than mycetoma. We report a case of cutaneous S. apiospermum infection occurred in 80-year-old male. The skin lesion was manifested by a 8.0 x 4.0 cm-sized erythematous plaque with pustules and crusts on the dorsum of right hand. The fungal culture from the biopsy specimen on Sabouraud's dextrose agar showed white to gray colored cottony colonies of S. apiospermum. The nucleotide sequence of internal transcribed spacer for clinical isolate was identical to that of S. apiospermum strain IHEM 23829. The patient was treated with oral fluconazole for 3 months.
Agar ; Aged, 80 and over ; Base Sequence ; Biopsy ; Fluconazole ; Fungi ; Glucose ; Hand ; Humans ; Male ; Mycetoma ; Pseudallescheria ; Scedosporium* ; Sequence Analysis, DNA* ; Sewage ; Skin* ; Soil

PURPOSE: To report a case of fungal keratitis caused by Scedosporium apiospermum. CASE SUMMARY: A 70-year-old man visited our clinic with complaints of redness and decreased visual acuity in his right eye caused by a soil gotten into an eye while gardening 10 days ago. The patient had previously been treated in a local clinic but did not show significant clinical improvement. Bacterial and fungal staining, culture, and an antibiotic sensitivity test were performed from a corneal scrape. The cultures revealed growth of Scedosporium apiospermum. The patient was treated with topical moxifloxacin antibiotics, fluconazole, amphotericin B antifungal agents. However, the lesion was not improved, so antifungal therapy was switched to topical voriconazole. After two months of treatment, the infection was resolved with mild scarring. CONCLUSIONS: Although it is a rare pathogen, Scedosporium apiospermum should be considered as a potential pathogen in patients presenting with corneal ulceration due to trauma from an object contaminated by soil, polluted water, or spoiled plant contact. And we suggest that topical application of voriconazole may be a good alternative treatment for patient with fungal keratitis in which no improvement despite a conventional antifungal agent, fluconazole.
Amphotericin B ; Anti-Bacterial Agents ; Antifungal Agents ; Aza Compounds ; Corneal Ulcer ; Eye ; Fluconazole ; Gardening ; Humans ; Keratitis ; Plants ; Pyrimidines ; Quinolines ; Scedosporium ; Soil ; Triazoles ; Visual Acuity

Scedosporium apiospermum, an asexual state of Pseudallescheria boydii, is a widely distributed mould that can be found in the soil, manure, stagnant water and decaying vegetation. It has become an emerging pathogen among immunosuppressed patients but it can also cause infections in immunocompetent patients by penetrating trauma. This fungus is a classical cause of mycetoma and the localized skin infections caused by this mould are much rarer than mycetoma. We report a case of cutaneous S. apiospermum infection in a 79-year-old woman. She had erythematous plaque with crust and violaceous supprative nodules on the right forearm. The culture from pus showed typical white to gray colored cottony colonies of S. apiospermum. Treatment was started with voriconazole effectively. Skin lesions completely cured with no reccurence. Thus, voriconazole shows to be an effective treatment for Scedosporium infection.
Female ; Forearm ; Fungi ; Humans ; Manure ; Mycetoma ; Pseudallescheria ; Pyrimidines ; Scedosporium ; Skin ; Soil ; Suppuration ; Triazoles

Scedosporium(S) apiospermum is the asexual stage of Pseudallescheria boydii. The organism has been isolated from polluted water, soil, sewage and potted plants in a hospital with low virulence. This ubiquitous fungus causes not only mycetoma, but also infections of variety of body sites including the skin. Localized skin infection without grain production due to this organism is much rarer than mycetoma. Infection may occur via direct inoculation and usually affects the extremities. We report a case of localized cutaneous infection due to S. apiospermum which occurred in a 79-year old female. She presented multiple erythematous papulopustules on the right wrist. Culture isolation for definitive diagnosis showed S. apiospermum. The patient was treated successfully with oral itraconazole 200 mg daily for 4 weeks.
Edible Grain ; Extremities ; Female ; Fungi ; Humans ; Itraconazole ; Mycetoma ; Pseudallescheria ; Scedosporium ; Sewage ; Skin ; Soil ; Wrist

Scedosporium apiospermum is a rising opportunistic fungus that may infect immunocompetent individuals and may cause often fatal disease among the increasing immunosuppressed patient population. This pathogen is typically difficult to treat because of its particular resistance to commonly used antimycotic drugs. We describe an 83-year-old male patient with a history of long-term corticosteroid treatment for chronic prurigo simplex, who developed multiple suppurative nodules on a erythematous plaque at the right forearm. Histological examinations revealed granulomatous infiltration with hyphae and spores in dermis and fungal cultured isolation for definitive diagnosis showed S. apiospermum. Treatment was started with oral fluconazole, but skin lesions were getting worse. Then patient was treated with 200 mg of intravenouse itraconazole daily. Skin lesions showed a marked improvement after 1 week, and completely healing after 3 weeks.
Aged, 80 and over ; Dermis ; Fluconazole ; Forearm ; Fungi ; Humans ; Hyphae ; Itraconazole ; Male ; Methylmethacrylates ; Polystyrenes ; Prurigo ; Scedosporium ; Skin ; Spores

Scedosporium apiospermum, an asexual form of Pseudallescheria boydii, is a saprophytic mold with a worldwide distribution. It may cause severe pulmonary or disseminated infections in immunocompromised patients who have undergone organ transplantation, have hematological malignancies, or have received corticosteroid therapy. However, in immunocompetent patients, it usually produces localized infection and has been reported to cause pneumonia after near-drowning in polluted water. We present here the case of an immunocompetent 72-year-old woman with pneumonia caused by S. apiospermum.
Aged ; Female ; Fungi ; Hematologic Neoplasms ; Humans ; Immunocompromised Host ; Near Drowning ; Organ Transplantation ; Pneumonia ; Pseudallescheria ; Scedosporium ; Transplants