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Epidemiology, clinical manifestations, and diagnosis of Scedosporium infection

Authors
Sylvia F Costa, MD
Barbara D Alexander, MD, MHS
Section Editor
Carol A Kauffman, MD
Deputy Editor
Anna R Thorner, MD

INTRODUCTION

During the past few decades, opportunistic fungal pathogens have become increasingly recognized as a cause of infection in severely ill or immunocompromised patients [1,2]. Although Aspergillus species remains the most common mold to cause invasive infection, other mold infections, such as those due to Scedosporium, are becoming more common [1-3]. Two members of this genus, Scedosporium apiospermum and Scedosporium prolificans, are considered major human pathogens [4].

The epidemiology, clinical manifestations, and diagnosis of Scedosporium infections will be reviewed here. The treatment of these infections is discussed elsewhere. (See "Treatment of Scedosporium infection".)

MYCOLOGY

Scedosporium apiospermum complex — S. apiospermum [5] is the asexual form (anamorph) of Pseudallescheria boydii [6-9]. Colonies grow rapidly and have a cottony appearance on cornmeal agar; with age, the colonies become gray or brown in color (picture 1). The hyphal forms appear as branching septate hyphae with a single terminal conidia, which is uninucleate and cylindrical in shape (picture 2) [10].

When the sexual form of S. apiospermum is present in culture, the organism is identified as P. boydii. Dark, spherical structures, known as cleistothecia, characterize the sexual form of this organism (picture 3) [11].

Scedosporium apiospermum complex has been recognized to encompass several distinct species. Through the use of molecular phylogeny, the following species have been accepted as unique: P. apiosperma (anamorph S. apiospermum), S. aurantiacum, P. boydii (S. boydii), S. dehoogii, and P. minutispora [12]. Identification to the species level is of interest since the susceptibility patterns differ among members of the S. apiospermum complex. (See "Treatment of Scedosporium infection", section on 'Scedosporium aurantiacum'.)

                           

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