Infectious Disease Compendium

Scedosporium (aka Pseudallescheria)

Microbiology

A fungus, includes S. apiospermum, S. prolificans (inflatum).

Epidemiologic Risks

More common in temperate areas, it has been found in soil, animals and "brackish water and saltwater, sewage, soil, swamps, coastal tidelands, manure of poultry (chicken coop, bird guano) and cattle, and bat feces (PubMed). "

Syndromes

The occasional pneumonia and disseminated disease in the immunoincompetent, skin and joint infections (mycetoma) in normal hosts. Can also cause eye infection after penetrating injury (PubMed).

Infections in near drowning.

Treatment

Debride as much as is humanly possible.

Possibly, maybe, perhaps voriconazole, posaconazole and ravuconazole based on in vitro reports and a smattering of case reports. Perhaps combined with terbinafine.

Usually resistant to amphotericin B, fluconazole, intermediate to caspofungin. In one series, if susceptible, about 60% of patients responded to long term voriconazole (PubMed), esp if they were infected with Scedosporium prolificans.

Notes

Curious Cases

Relevant links to my Medscape blog

Is It Real?

Last Update: 05/22/18.