AJMB2103 - CME/CMLE - Scedosporium and Lomentospora Infections Are Infrequent, Difficult to Diagnose by Histology, and Highly Virulent-Scedosporium and Lomentospora Infections Are Infrequent, Difficult to Diagnose by Histology, and Highly Virulent

Scedosporium and Lomentospora Infections Are Infrequent, Difficult to Diagnose by Histology, and Highly Virulent

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The document discusses the characteristics of colonization and invasive disease caused by Scedosporium and Lomentospora fungi in immunocompromised patients. A 20-year retrospective study analyzed 18 patients with these infections, revealing that all patients were immunocompromised, with most having undergone transplantation or having autoimmune disorders. Clinical presentations included skin lesions, pneumonia, and disseminated disease. Histopathological analysis revealed findings such as hyaline septate hyphae, obovoidal microconidia, and annellide-like structures, aiding in the diagnosis of non-Aspergillus hyalohyphomycosis. Treatment involved surgical debridement and antifungal therapy, but despite therapy, the mortality rate was high, especially among patients with disseminated disease. Molecular methods are recommended for accurate species identification. The study highlights the importance of careful clinical, histopathologic, and microbiologic correlation for diagnosis, emphasizing the need for early consideration of these fungal infections in immunocompromised patients for aggressive management. Challenges in accurately identifying Scedosporium and Lomentospora species require expertise and molecular confirmation to guide appropriate treatment. The study underscores the severe nature of these infections, emphasizing the importance of preventive measures and timely diagnosis for improving patient outcomes.

Keywords

colonization

invasive disease

Scedosporium

Lomentospora

immunocompromised patients

retrospective study

non-Aspergillus hyalohyphomycosis

antifungal therapy

molecular methods

fungal infections