Infections caused by Scedosporium spp.

Karoll J. Cortez, Emmanuel Roilides, Flavio Quiroz-Telles, Joseph Meletiadis, Charalampos Antachopoulos, Tena Knudsen, Wendy Buchanan, Jeffrey Milanovich, Deanna A. Sutton, Annette Fothergill, Michael G. Rinaldi, Yvonne R. Shea, Theoklis Zaoutis, Shyam Kottilil, Thomas J. Walsh

Research output: Contribution to journalReview articlepeer-review

473 Scopus citations

Abstract

Scedosporium spp. are increasingly recognized as causes of resistant life-threatening infections in immunocompromised patients. Scedosporium spp. also cause a wide spectrum of conditions, including mycetoma, saprobic involvement and colonization of the airways, sino-pulmonary infections, extrapulmonary localized infections, and disseminated infections. Invasive scedosporium infections are also associated with central nervous infection following near-drowning accidents. The most common sites of infection are the lungs, sinuses, bones, joints, eyes, and brain. Scedosporium apiospermum and Scedosporium prolificans are the two principal medically important species of this genus. Pseudallescheria boydii, the teleomorph of S. apiospermum, is recognized by the presence of cleistothecia. Recent advances in molecular taxonomy have advanced the understanding of the genus Scedosporium and have demonstrated a wider range of species than heretofore recognized. Studies of the pathogenesis of and immune response to Scedosporium spp. underscore the importance of innate host defenses in protection against these organisms. Microbiological diagnosis of Scedosporium spp. currently depends upon culture and morphological characterization. Molecular tools for clinical microbiological detection of Scedosporium spp. are currently investigational. Infections caused by S. apiospermum and P. boydii inpatients and animals may respond to antifungal triazoles. By comparison, infections caused by S. prolificans seldom respond to medical therapy alone. Surgery and reversal of immunosuppression may be the only effective therapeutic options for infections caused by S. prolificans.

Original languageEnglish (US)
Pages (from-to)157-197
Number of pages41
JournalClinical Microbiology Reviews
Volume21
Issue number1
DOIs
StatePublished - Jan 2008
Externally publishedYes

ASJC Scopus subject areas

  • General Medicine

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