Open AccessScedosporium prolificans Osteomyelitis in an Immunocompetent Child Treated with Voriconazole and Caspofungin, as Well as Locally Applied Polyhexamethylene Biguanide
Author(s) -
William J. Steinbach,
Wiley A. Schell,
Jackie L. Miller,
John R. Perfect
Publication year - 2003
Publication title -
journal of clinical microbiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.349
H-Index - 255
eISSN - 1070-633X
pISSN - 0095-1137
DOI - 10.1128/jcm.41.8.3981-3985.2003
Subject(s) - voriconazole , caspofungin , osteomyelitis , medicine , anidulafungin , micafungin , echinocandin , amphotericin b , microbiology and biotechnology , biguanide , biology , surgery , antifungal , dermatology , fluconazole , metformin , insulin
Scedosporium species are increasingly isolated from immunocompromised and immunocompetent patients. Unfortunately, Scedosporium infections are generally resistant to amphotericin B, and Scedosporium prolificans strains are particularly resistant to the antifungal agents now in use. We report here on an immunocompetent child with S. prolificans-associated osteomyelitis successfully treated with debridement, local irrigation with polyhexamethylene biguanide, and the systemic administration of voriconazole and caspofungin despite poor in vitro activity of voriconazole alone against the isolate. We also review the treatments and outcomes of 28 reported cases of osteomyelitis or septic arthritis caused by Scedosporium species in immunocompetent patients.