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Epidemiology, clinical manifestations, and diagnosis of Scedosporium and Lomentospora infections

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


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 remain the most common mold to cause invasive infection, other mold infections are becoming more common [1-3]. Two of these, Scedosporium apiospermum and Lomentospora prolificans, are considered major human pathogens [4].

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


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].

S. apiospermum complex has been recognized to encompass several distinct species. Through the use of molecular phylogeny, the following species have been accepted as unique: Pseudallescheria apiosperma (anamorph S. apiospermum), Scedosporium aurantiacum, P. boydii (Scedosporium boydii), Scedosporium dehoogii, and Pseudallescheria 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 and Lomentospora infections", section on 'Scedosporium aurantiacum'.)

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Literature review current through: Nov 2017. | This topic last updated: Oct 24, 2017.
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