Invasive Scedosporium Infections in Immunocompromised Patients
Summary
Invasive infections caused by Scedosporium species represent a significant and growing challenge in patients with compromised immunity. Members of this genus, including Scedosporium apiospermum, Scedosporium boydii and the closely related Lomentospora prolificans, can colonise the respiratory tract before disseminating to the skin, eyes, central nervous system and other deep tissues. Disease manifests variably, from indolent pulmonary colonisation to fulminant disseminated scedosporiosis with high mortality rates. Risk factors for severe disease include neutropaenia, haematological malignancy, solid organ or stem cell transplantation and the use of immunomodulatory therapies such as corticosteroids or cytokine inhibitors. Early diagnosis is often delayed by non-specific clinical signs and the need for specialised laboratory methods including culture on selective media, molecular identification and antifungal susceptibility testing. Therapeutic options remain limited by widespread resistance to amphotericin B and many azoles; voriconazole is considered first-line treatment but may require combination with terbinafine, echinocandins or investigational agents. Surgical debridement has an important adjunctive role in focal disease. Improved outcomes depend on prompt recognition, immune reconstitution where feasible and tailoring of antifungal therapy to species-specific susceptibility profiles. Global surveillance and standardised reporting are essential to guide future clinical strategies and to assess the impact of emerging antifungal compounds.
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Invasive Scedosporium Infections in Immunocompromised Patients publication trend
The graph below shows the total number of articles in invasive scedosporium infections in immunocompromised patients across all publications each year (not limited to Nature Index journals).
Technical terms
Immunocompromised patient: An individual whose immune defences are impaired by disease, medication or therapy, increasing susceptibility to opportunistic infections.
Minimal inhibitory concentration (MIC): The lowest concentration of an antifungal agent that inhibits visible growth of a microorganism in vitro.
Biofilm: A structured community of fungal cells adherent to a surface and embedded in an extracellular matrix, often associated with increased drug resistance.
Antifungal susceptibility: The responsiveness of a fungal isolate to antifungal agents, determined by standardised laboratory testing to inform therapeutic choices.
References
- Recurrent Scedosporium apiospermum Cutaneous Infection in a Patient with Rheumatoid Arthritis: The Potent Role of IL-6 Signaling Pathway Blockade: A Case-Based Review. Journal of Fungi (2023).
- In Vitro and In Vivo Effect of the Imidazole Luliconazole against Lomentospora prolificans and Scedosporium spp.. Microbiology Spectrum (2023).
- Scedosporium and Lomentospora Infections: Contemporary Microbiological Tools for the Diagnosis of Invasive Disease. Journal of Fungi (2021).
- Lomentospora prolificans: An Emerging Opportunistic Fungal Pathogen. Microorganisms (2022).
- Recent Advances in the Treatment of Scedosporiosis and Fusariosis. Journal of Fungi (2018).
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