Emerging Infectious Diseases (Jun 2024)

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

  • Carole Vignals,
  • Joseph Emmerich,
  • Hugues Begueret,
  • Dea Garcia-Hermoso,
  • Guillaume Martin-Blondel,
  • Adela Angoulvant,
  • Damien Blez,
  • Patrick Bruneval,
  • Sophie Cassaing,
  • Emilie Catherinot,
  • Pierre Cahen,
  • Cécile Moluçon-Chabrot,
  • Carole Chevenet,
  • Laurence Delhaes,
  • Lélia Escaut,
  • Marie Faruch,
  • Frédéric Grenouillet,
  • Fabrice Larosa,
  • Lucie Limousin,
  • Elisabeth Longchampt,
  • François Mellot,
  • Céline Nourrisson,
  • Marie-Elisabeth Bougnoux,
  • Olivier Lortholary,
  • Antoine Roux,
  • Laura Rozenblum,
  • Mathilde Puges,
  • Fanny Lanternier,
  • Didier Bronnimann

DOI
https://doi.org/10.3201/eid3006.231409
Journal volume & issue
Vol. 30, no. 6
pp. 1077 – 1087

Abstract

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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.

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