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Description

Scedosporiosis is a fungal infection caused by Scedosporium, generally in people with less ability to fight infection.[1][2][3] Current population-based studies suggest Scedosporium prolificans (Lomentospora prolificans) and Scedosporium apiospermum to be among the most common infecting agents from the genus,[4] although infections caused by other members thereof are not unheard of.[5] The latter is an asexual form (anamorph) of another fungus, Pseudallescheria boydii; the former is a "black yeast" (dematiaceous fungus).[6]In a 2005 study[6] scedosporal infections caused a 58 percent mortality rate for transplant recipients affected with it. Among individuals with cystic fibrosis, it is the second most common fungal infection.Moreover, a certain difficulty has been reported with correctly identifying the pathogen. As to management we find voriconazole is used, often combined with surgical debridement.[7][8]

Localized mycosis

Scedosporiosis can occur locally or spread out, through the body. Localized scedosporiosis can occur in a vast range of internal organs and in joints and limbs. It can commonly be found on the surface of the skin in a form of white and yellow papules. [5]

Disseminated mycosis

Severely immunocompromised individuals, individuals on immunosuppressive therapy, as well as those suffering from cancers including leukemia, have a risk of developing an infection that would constitute a spread of the extant localized infection throughout the organism.[5]

Presentation 1

In terms of presentation we find that Scedosporiosis symptoms vary depending on site of infection and the individuals immune status. They can include localized issues such as: [9][10][11]fever, skin nodules, and pneumonia.

Presentation 2

As to severe disseminated infections we find this affects:[10][12][13] brain, bones and bloodstream.

Cause

Lomentospora prolificans is an emerging opportunistic fungal pathogen that causes a wide variety of infections in immunologically normal and immunosuppressed people and animals.[14][15][16]

Risk factors

In terms of risk factors for Scedosporiosis we find the following:[3] solid organ transplantation, chemotherapy and chronic lung disease.

Diagnosis

In terms of the evaluation of Scedosporiosis in the affected individual we find:[17][18] medical exam, MRI, CT and culture.

Differential diagnosis

In terms of the differential diagnosis in the affected individual we find the following:[19][18] Invasive aspergillosis, Mucormycosis and Fusariosis.

Treatment

Effective treatment against Scedosporiosis continues to present a challenge to modern medicine - as do many other fungal infections,and can vary depending on the localization and type of infection.Voriconazole is used, often combined with surgical debridement. Posaconazole and terbinafine may be considered in refractory cases.[9][20][11]

Prognosis

The prognosis of scedosporiosis is generally poor, especially in immunocompromised individuals. Mortality rates can range from 30 to 55 percent in invasive Scedosporium infections.[18]

Epidemiology

As to epidemiology we find that S. apiospermum has a uniform worldwide distribution, while L. prolificans shows regional clustering, especially in Australia, Spain, U.S. and certain parts of Europe.[21][4]

History

First detectable description of a scedosporal disease arises in 1911[6] where S. apiospermum was identified as a cause of human mycetoma – a deep fungal subcutaneous infection. S. apiospermum is, indeed, not a recently discovered human pathogen and data about it have been aggregated over a period of more than 120 years.[7] S. prolificans, on the other hand, was discovered more recently, in 1974, under the name L. prolificans.[22]

Society and culture

In many well known natural disasters, such as the 2011 Japan Tsunami, survivors who initially made it through the water often developed brain abscesses weeks later caused by Scedosporium.This because survivors who aspirated heavily contaminated water, later developed lung infections followed by multiple brain abscesses.[23]

Research

Recent medical advances show hope for more efficient antifungal therapies, as novel drugs like Ibrexafungerp - a glucan synthase inhibitor - is somewhat effective in treating S. prolificans infections. Another drug, Fosmanogepix, showed in vitro efficacy as treatment for scedosporiosis (including S. prolificans). Olorofim, a new dihydroorotate dehydrogenase inhibitor - which disrupts pyrimidine biosynthesis, is also deserving of attention as it showed efficacy against both S. prolificans and S. apiospermum as well as other fungi known to be universally resistant to known antifungal medications.[24]

References

  1. ↑ "ICD-11 - ICD-11 for Mortality and Morbidity Statistics". icd.who.int. Archived from the original on 1 August 2018. Retrieved 11 July 2021.
  2. ↑ WHO fungal priority pathogens list to guide research, development and public health action. World Health Organization. 25 October 2022. p. 26. ISBN 978-92-4-006024-1.
  3. ↑ 3.0 3.1 "Orphanet: Scedosporiosis". www.orpha.net. Retrieved 25 November 2025.
  4. ↑ 4.0 4.1 Heath CH, Slavin MA, Sorrell TC, Handke R, Harun A, Phillips M, et al. (July 2009). "Population-based surveillance for scedosporiosis in Australia: epidemiology, disease manifestations and emergence of Scedosporium aurantiacum infection". Clinical Microbiology and Infection. 15 (7): 689–93. doi:10.1111/j.1469-0691.2009.02802.x. PMID 19549223.
  5. ↑ 5.0 5.1 5.2 Ramirez-Garcia A, Pellon A, Rementeria A, Buldain I, Barreto-Bergter E, Rollin-Pinheiro R, et al. (April 2018). "Scedosporium and Lomentospora: an updated overview of underrated opportunists". Medical Mycology. 56 (suppl_1): 102–125. doi:10.1093/mmy/myx113. PMID 29538735.
  6. ↑ 6.0 6.1 6.2 Husain S, Muñoz P, Forrest G, Alexander BD, Somani J, Brennan K, et al. (January 2005). "Infections due to Scedosporium apiospermum and Scedosporium prolificans in transplant recipients: clinical characteristics and impact of antifungal agent therapy on outcome". Clinical Infectious Diseases. 40 (1): 89–99. doi:10.1086/426445. PMID 15614697.
  7. ↑ 7.0 7.1 Guarro J, Kantarcioglu AS, Horré R, Rodriguez-Tudela JL, Cuenca Estrella M, Berenguer J, de Hoog GS (June 2006). "Scedosporium apiospermum: changing clinical spectrum of a therapy-refractory opportunist". Medical Mycology. 44 (4): 295–327. doi:10.1080/13693780600752507. PMID 16772225.
  8. ↑ Nagano Y, Cherie MB, Goldsmith CE, Stuart EJ, Rendall J, Moore JE (2009-01-08). "Emergence of Scedosporium apiospermum in patients with cystic fibrosis". BMJ Case Reports. 2009 (jan08 1): bcr2007119503. doi:10.1136/bcr.2007.119503. PMC 3034750. PMID 21687279.
  9. ↑ 9.0 9.1 Seidel, Danila; Meißner, Arne; Lackner, Michaela; Piepenbrock, Ellen; Salmanton-García, Jon; Stecher, Melanie; Mellinghoff, Sibylle; Hamprecht, Axel; Durán Graeff, Luisa; Köhler, Philipp; Cheng, Matthew P.; Denis, Julie; Chedotal, Isabelle; Chander, Jagdish; Pakstis, Diana Lynn; Los-Arcos, Ibai; Slavin, Monica; Montagna, Maria Teresa; Caggiano, Giuseppina; Mares, Mihai; Trauth, Janina; Aurbach, Ute; Vehreschild, Maria J. G. T.; Vehreschild, Jörg Janne; Duarte, Rafael F.; Herbrecht, Raoul; Wisplinghoff, Hilmar; Cornely, Oliver A. (2 January 2019). "Prognostic factors in 264 adults with invasive Scedosporium spp. and Lomentospora prolificans infection reported in the literature and FungiScope®". Critical Reviews in Microbiology. 45 (1): 1–21. Bibcode:2019CRMic..45....1S. doi:10.1080/1040841X.2018.1514366. ISSN 1040-841X. PMID 30628529.
  10. ↑ 10.0 10.1 "Scedosporiosis | About the Disease | GARD". rarediseases.info.nih.gov. Retrieved 30 November 2025.
  11. ↑ 11.0 11.1 Soubani, Ayman O. (26 December 2024). Pulmonary Aspergillosis: A Comprehensive Guide to the Disease Spectrum and Advances in Diagnosis and Management. Springer Nature. p. 340. ISBN 978-3-031-76524-7.
  12. ↑ Yao, Yao; Xu, Qian; Liang, Wenwen; Ji, Suqiong; Kosari, Mohammadreza; Xu, Shabei; Zhu, Zhou; Mao, Zhijuan (15 April 2024). "Multi-organ involvement caused by Scedosporium apiospermum infection after near drowning: a case report and literature review". BMC neurology. 24 (1): 124. doi:10.1186/s12883-024-03637-9. ISSN 1471-2377. Archived from the original on 2 February 2025. Retrieved 14 December 2025.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  13. ↑ Reinhold, Ilana; Quiblier, Chantal; Blaser, Frank; Bögeholz, Jan; Imkamp, Frank; Schuurmans, Macé M; Soyka, Michael B; Zbinden, Reinhard; Mueller, Nicolas J (27 January 2024). "Detection of Scedosporium spp.: Colonizer or pathogen? A retrospective analysis of clinical significance and management in a large tertiary center". Medical Mycology. 62 (2). doi:10.1093/mmy/myae002.
  14. ↑ Cortez KJ, Roilides E, Quiroz-Telles F, et al. (2008). "Infections caused by Scedosporium spp". Clinical Microbiology Reviews. 21 (1): 157–97. doi:10.1128/CMR.00039-07. PMC 2223844. PMID 18202441.
  15. ↑ Elad, Daniel (1 January 2011). "Infections caused by fungi of the Scedosporium/Pseudallescheria complex in veterinary species". The Veterinary Journal. 187 (1): 33–41. doi:10.1016/j.tvjl.2010.05.028. PMID 20580291.
  16. ↑ Rodriguez-Tudela, Juan Luis; Rodriguez-Tudela, Juan Luis; Berenguer, Juan; Guarro, Josep; Kantarcioglu, A. Serda; Horre, Regine; Sybren De Hoog, G.; Cuenca-Estrella, Manuel (1 January 2009). "Epidemiology and outcome of Scedosporium prolificans infection, a review of 162 cases". Medical Mycology. 47 (4): 359–370. doi:10.1080/13693780802524506. PMID 19031336.
  17. ↑ Longo, Dan; Fauci, Anthony; Kasper, Dennis; Hauser, Stephen; Jameson, J.; Loscalzo, Joseph (21 July 2011). Harrison's Principles of Internal Medicine, 18th Edition. McGraw Hill Professional. p. 1668. ISBN 978-0-07-174889-6.
  18. ↑ 18.0 18.1 18.2 Neoh, Chin Fen; Chen, Sharon C-A; Lanternier, Fanny; Tio, Shio Yen; Halliday, Catriona L.; Kidd, Sarah E.; Kong, David C. M.; Meyer, Wieland; Hoenigl, Martin; Slavin, Monica A. (29 March 2024). "Scedosporiosis and lomentosporiosis: modern perspectives on these difficult-to-treat rare mold infections". Clinical Microbiology Reviews. 37 (2): e00004–23. doi:10.1128/cmr.00004-23. PMC 11237582. PMID 38551323.
  19. ↑ Al Refaï, M (May 2002). "Lung scedosporiosis: a differential diagnosis of aspergillosis". European Journal of Cardio-Thoracic Surgery. 21 (5): 938–939. doi:10.1016/S1010-7940(02)00068-4. ISSN 1010-7940. PMID 12062297. Archived from the original on 2 December 2023. Retrieved 29 November 2025.
  20. ↑ Troke, Peter; Aguirrebengoa, Koldo; Arteaga, Carmen; Ellis, David; Heath, Christopher H.; Lutsar, Irja; Rovira, Montserrat; Nguyen, Quoc; Slavin, Monica; Chen, Sharon C. A. (May 2008). "Treatment of Scedosporiosis with Voriconazole: Clinical Experience with 107 Patients". Antimicrobial Agents and Chemotherapy. 52 (5): 1743–1750. doi:10.1128/aac.01388-07. PMC 2346616. PMID 18212110.
  21. ↑ Subedi, Shradha; Chen, Sharon C.-A. (1 December 2015). "Epidemiology of Scedosporiosis". Current Fungal Infection Reports. 9 (4): 275–284. doi:10.1007/s12281-015-0243-0. ISSN 1936-377X. Archived from the original on 10 June 2018. Retrieved 23 November 2025.
  22. ↑ "Lomentospora prolificans Hennebert & B.G.Desai, 1974". www.gbif.org. Retrieved 6 December 2025.
  23. ↑ Nakamura, Yutaka; Utsumi, Yu; Suzuki, Naomi; Nakajima, Yoshio; Murata, Okinori; Sasaki, Nobuhito; Nitanai, Hiroo; Nagashima, Hiromi; Miyamoto, Shinya; Yaegashi, Jun; Hatakeyama, Tomoki; Shibano, Yoshihiro; Yarita, Kyoko; Kamei, Katsuhiko; Nakadate, Toshihide; Endo, Shigeatsu; Terayama, Yasuo; Yamauchi, Kohei (25 October 2011). "Multiple Scedosporium apiospermum abscesses in a woman survivor of a tsunami in northeastern Japan: a case report". Journal of Medical Case Reports. 5 (1): 526. doi:10.1186/1752-1947-5-526. ISSN 1752-1947.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  24. ↑ Rauseo AM, Coler-Reilly A, Larson L, Spec A (February 2020). "Hope on the Horizon: Novel Fungal Treatments in Development". Open Forum Infectious Diseases. 7 (2) ofaa016. doi:10.1093/ofid/ofaa016. PMC 7031074. PMID 32099843.
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