Deciphering Unexpected Vascular Locations of Scedosporium spp. and Lomentospora prolificans Fungal Infections, France

Emerg Infect Dis. 2024 Jun;30(6):1077-1087. doi: 10.3201/eid3006.231409.

Abstract

Scedosporium spp. and Lomentospora prolificans are emerging non-Aspergillus filamentous fungi. The Scedosporiosis/lomentosporiosis Observational Study we previously conducted reported frequent fungal vascular involvement, including aortitis and peripheral arteritis. For this article, we reviewed 7 cases of Scedosporium spp. and L. prolificans arteritis from the Scedosporiosis/lomentosporiosis Observational Study and 13 cases from published literature. Underlying immunosuppression was reported in 70% (14/20) of case-patients, mainly those who had solid organ transplants (10/14). Osteoarticular localization of infection was observed in 50% (10/20) of cases; infections were frequently (7/10) contiguous with vascular infection sites. Scedosporium spp./Lomentospora prolificans infections were diagnosed in 9 of 20 patients ≈3 months after completing treatment for nonvascular scedosporiosis/lomentosporiosis. Aneurysms were found in 8/11 aortitis and 6/10 peripheral arteritis cases. Invasive fungal disease--related deaths were high (12/18 [67%]). The vascular tropism of Scedosporium spp. and L. prolificans indicates vascular imaging, such as computed tomography angiography, is needed to manage infections, especially for osteoarticular locations.

Keywords: France; Lomentospora; Lomentospora prolificans; Scedosporium; aortitis; arteritis; fungi; lomentosporiosis; mycotic aneurysm; scedosporiosis; vascular infections.

Publication types

  • Observational Study
  • Review

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antifungal Agents / therapeutic use
  • Female
  • France / epidemiology
  • Humans
  • Invasive Fungal Infections
  • Male
  • Middle Aged
  • Mycoses* / diagnosis
  • Mycoses* / epidemiology
  • Mycoses* / microbiology
  • Scedosporium* / isolation & purification

Substances

  • Antifungal Agents

Supplementary concepts

  • scedosporiosis