3 research outputs found
Prognostic factors in 264 adults with invasive Scedosporium spp. and Lomentospora prolificans infection reported in the literature and FungiScope
Invasive Scedosporium spp. and Lomentospora prolificans infections are an emerging threat in
immunocompromised and occasionally in healthy hosts. Scedosporium spp. is intrinsically resistant
to most, L. prolificans to all the antifungal drugs currently approved, raising concerns about
appropriate treatment decisions. High mortality rates of up to 90% underline the need for comprehensive
diagnostic workup and even more for new, effective antifungal drugs to improve
patient outcome. For a comprehensive analysis, we identified cases of severe Scedosporium spp.
and L. prolificans infections from the literature diagnosed in 2000 or later and the FungiScopeVR
registry. For 208 Scedosporium spp. infections solid organ transplantation (nÂĽ58, 27.9%) and for
56 L. prolificans infection underlying malignancy (nÂĽ28, 50.0%) were the most prevalent risk factors.
L. prolificans infections frequently presented as fungemia (nÂĽ26, 46.4% versus nÂĽ12, 5.8%
for Scedosporium spp.). Malignancy, fungemia, CNS and lung involvement predicted worse outcome
for scedosporiosis and lomentosporiosis. Patients treated with voriconazole had a better
overall outcome in both groups compared to treatment with amphotericin B formulations. This
review discusses the epidemiology, prognostic factors, pathogen susceptibility to approved
and investigational antifungals, and treatment strategies of severe infections caused by Scedosporium spp. and L. prolificansWe thank Sabine Wrackmeyer for her private donation to
support the projec