Recurrent Scedosporium apiospermum mycetoma successfully treated by surgical excision and terbinafine treatment: a case report and review of the literature
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 infection...
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| Format: | Article |
| Language: | English |
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BMC
2017-04-01
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| Series: | Annals of Clinical Microbiology and Antimicrobials |
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| Online Access: | http://link.springer.com/article/10.1186/s12941-017-0195-z |
| _version_ | 1818526802142822400 |
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| author | Eszter J. Tóth Géza R. Nagy Mónika Homa Marianna Ábrók Ildikó É. Kiss Gábor Nagy Zsuzsanna Bata-Csörgő Lajos Kemény Edit Urbán Csaba Vágvölgyi Tamás Papp |
| author_facet | Eszter J. Tóth Géza R. Nagy Mónika Homa Marianna Ábrók Ildikó É. Kiss Gábor Nagy Zsuzsanna Bata-Csörgő Lajos Kemény Edit Urbán Csaba Vágvölgyi Tamás Papp |
| author_sort | Eszter J. Tóth |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-11T06:27:55Z |
| format | Article |
| id | doaj.art-ab0dcf036748447eb34320966ea3ec1e |
| institution | Directory Open Access Journal |
| issn | 1476-0711 |
| language | English |
| last_indexed | 2024-12-11T06:27:55Z |
| publishDate | 2017-04-01 |
| publisher | BMC |
| record_format | Article |
| series | Annals of Clinical Microbiology and Antimicrobials |
| spelling | doaj.art-ab0dcf036748447eb34320966ea3ec1e2022-12-22T01:17:37ZengBMCAnnals of Clinical Microbiology and Antimicrobials1476-07112017-04-011611910.1186/s12941-017-0195-zRecurrent Scedosporium apiospermum mycetoma successfully treated by surgical excision and terbinafine treatment: a case report and review of the literatureEszter J. Tóth0Géza R. Nagy1Mónika Homa2Marianna Ábrók3Ildikó É. Kiss4Gábor Nagy5Zsuzsanna Bata-Csörgő6Lajos Kemény7Edit Urbán8Csaba Vágvölgyi9Tamás Papp10MTA-SZTE “Lendület” Fungal Pathogenicity Mechanisms Research Group, Hungarian Academy of Sciences, University of SzegedDepartment of Dermatology and Allergology, Albert Szent-Györgyi Medical Centre, University of SzegedMTA-SZTE “Lendület” Fungal Pathogenicity Mechanisms Research Group, Hungarian Academy of Sciences, University of SzegedInstitute of Clinical Microbiology, Albert Szent-Györgyi Medical Centre, University of SzegedInstitute of Clinical Microbiology, Albert Szent-Györgyi Medical Centre, University of SzegedMTA-SZTE “Lendület” Fungal Pathogenicity Mechanisms Research Group, Hungarian Academy of Sciences, University of SzegedDepartment of Dermatology and Allergology, Albert Szent-Györgyi Medical Centre, University of SzegedDepartment of Dermatology and Allergology, Albert Szent-Györgyi Medical Centre, University of SzegedInstitute of Clinical Microbiology, Albert Szent-Györgyi Medical Centre, University of SzegedDepartment of Microbiology, Faculty of Science and Informatics, University of SzegedMTA-SZTE “Lendület” Fungal Pathogenicity Mechanisms Research Group, Hungarian Academy of Sciences, University of SzegedAbstract 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.http://link.springer.com/article/10.1186/s12941-017-0195-zFilamentous fungiCutaneous infectionAntifungal susceptibilityImmunosuppressionCorticosteroid therapyScedosporium apiospermum |
| spellingShingle | Eszter J. Tóth Géza R. Nagy Mónika Homa Marianna Ábrók Ildikó É. Kiss Gábor Nagy Zsuzsanna Bata-Csörgő Lajos Kemény Edit Urbán Csaba Vágvölgyi Tamás Papp Recurrent Scedosporium apiospermum mycetoma successfully treated by surgical excision and terbinafine treatment: a case report and review of the literature Annals of Clinical Microbiology and Antimicrobials Filamentous fungi Cutaneous infection Antifungal susceptibility Immunosuppression Corticosteroid therapy Scedosporium apiospermum |
| title | Recurrent Scedosporium apiospermum mycetoma successfully treated by surgical excision and terbinafine treatment: a case report and review of the literature |
| title_full | Recurrent Scedosporium apiospermum mycetoma successfully treated by surgical excision and terbinafine treatment: a case report and review of the literature |
| title_fullStr | Recurrent Scedosporium apiospermum mycetoma successfully treated by surgical excision and terbinafine treatment: a case report and review of the literature |
| title_full_unstemmed | Recurrent Scedosporium apiospermum mycetoma successfully treated by surgical excision and terbinafine treatment: a case report and review of the literature |
| title_short | Recurrent Scedosporium apiospermum mycetoma successfully treated by surgical excision and terbinafine treatment: a case report and review of the literature |
| title_sort | recurrent scedosporium apiospermum mycetoma successfully treated by surgical excision and terbinafine treatment a case report and review of the literature |
| topic | Filamentous fungi Cutaneous infection Antifungal susceptibility Immunosuppression Corticosteroid therapy Scedosporium apiospermum |
| url | http://link.springer.com/article/10.1186/s12941-017-0195-z |
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