Pneumonia caused byScedosporium in non-Transplant and non-HIV-infected adults:A
case series and review of the literature
Aixia Wang1,2, Ping Yang1, Yanrong
Gong1, Yafeng Wang2, Na
Chen*1
1. Department of Parmaceutical, The First Affiliated Hospital, Zhejiang
University School of Medicine, Hangzhou, 310003, China
2.Department of Parmaceutical, Qinghai Provincial People’s
Hospital,Xining, 810007, China;
Abstract The lung is one of the most commonly encountered sites
of Scedosporium infection. Due to its intrinsic resistance to all
current antifungal agents, treatment of Scedosporium infections
still remains a great challenge. Voriconazole has been recommended to
the first-line systemic treatment of Scedosporium infections, but
the duration is not well recommended, especially for immunocompetent
patients. This case series presented our experience on diagnostic,
manifestation, and treatment strategies of Scedosporiumpneumonia. The case records of non-Transplanted non-HIV adults withScedosporium pneumonia hospitalized in our Hospital from January
2020 to February 2022 were retrospectively analyzed, and their case
characteristics, antifungal therapy drug selection and treatment course
were summarized: All 3 patients had underlying lung disease, 2 female
patients had a history of bronchiectasis, and 1 male patient had a
history of emphysema. Both female patients had a mixed infection withScedosporium and nontuberculous mycobacteria. In one female
patients, Scedosporium was no longer detected after 2 months of
treatment with voriconazole, and the clinical symptoms were improved
than before, with no significant change in imaging. In one female
patient, although Scedosporium was still isolated from sputum
after 12 months with voriconazole treatment, the symptoms were improved
than before, and antifungal therapy was discontinued after no
significant improvement 1 and a half months after switching to
Posaconazole. In one male patient, Scedosporium was no longer
detected after 3 months treatment with voriconazole, and the clinical
symptoms and imaging were significantly improved. Three patients had
voriconazole concentrations between 1.1-2.8 μg/mL during treatment.
KEY WORDS: Scedosporium ; pneumonia; voriconazole