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Scedosporium apiospermum presenting as a pulmonary mycetoma in immunocompetent male
Author(s) -
Gupta Ekta,
Shibli Muhammad,
Gibbons Junette
Publication year - 2010
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.24.1_supplement.lb429
Subject(s) - scedosporium apiospermum , medicine , bronchoalveolar lavage , tuberculosis , lung transplantation , mycetoma , mycosis , lung , surgery , pathology , dermatology , voriconazole , antifungal , transplantation
Background Scedosporium apiospermum the anamorph of the ascomycete Pdeudoallescheria boydii, is a significant opportunist with very high levels of antifungal resistance. Colonization of Scedosporium apiospermum is a rare event, which eventually occurs on previous damaged lung tissue such as cavity or a lung cyst. We report this rare case of pulmonary scedosporiosis in an immunocompetent male treated many years ago for pulmonary tuberculosis. Case presentation A 42 year old Ethiopian male with past medical history of successfully treated Pulmonary Tuberculosis, presented with cough and Hemoptysis off and on for the last few months, which got worse for 3 days. Imaging showed cavitary lesion in the right upper lobe of lung. Bronchoalveolar lavage after bronchoscopy was negative for AFB smear and culture. Patient had an episode of massive hemoptysis and was electively intubated for right upper and middle lobectomy. Patient felt better after surgery, and no further episode of Hemoptysis was reported. Later, bronchoalveolar lavage cultures grew – Scedosporium apiospermum. Conclusion Scedosporium apiospermum infection is an emerging, potentially life‐threatening disease category which is difficult to diagnose and treat. In lungs, it is easily misidentified as Aspergillus, especially in post tubercular cavitary lesion. Even in culture, the species is frequently not recognized due to its morphological plasticity. This case is reported to highlight a rising incidence of this potentially lethal infection and the prognostic significance of early detection and therapy.