Clinical features and antifungal treatment of invasive Scedosporium boydii infection: report of a case and literature overview.

IF 4.6 2区医学 Q1 MICROBIOLOGY Annals of Clinical Microbiology and Antimicrobials Pub Date : 2024-10-18 DOI:10.1186/s12941-024-00754-8

Yanping Xiao, Xiaolin Li, Longhua Hu, Yuhui Xu, Xingwei Cao, Qiaoshi Zhong

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Abstract

Objective: This study aims to present a case of persistent mycetoma caused by Scedosporium boydii and undertake a systematic literature overview to elucidate the clinical characteristics and antifungal treatment exhibited by such patients.

Methods: We report the case of a 24-year-old female who sustained a Scedosporium boydii infection in her right foot over a decade ago following a nail puncture. Concurrently, a comprehensive literature overview was conducted on PubMed, focusing on documented cases of Scedosporium boydii infections with the intent of extracting relevant clinical data.

Results: Our analysis revealed that post-transplantation, trauma, near drowning, corticosteroid administration, and prior surgical history were the main risk factors for Scedosporium boydii infection. Prevalent infection sites included skin/bone tissues, the central nervous system, and ocular regions. Among the 49 patients identified, 24 received itraconazole therapy and 25 received voriconazole, with no significant difference in patient outcomes (P = 0.158). Of these, 12 patients experienced treatment failure. Notably, prolonged antifungal treatment duration was identified as a protective factor against mortality in Scedosporium boydii infections [P = 0.022, OR(95%CI): 0.972(0.949-0.996)]. Conversely, a history of post-transplantation emerged as a potential risk factor for mortality[P = 0.046, OR(95%CI): 7.017(1.034-47.636)].

Conclusion: While uncommon, Scedosporium boydii infections carry a significant burden of morbidity and adverse outcomes. Heightened clinical vigilance is warranted in individuals presenting with risk factors for this pathogen. Timely and effective antifungal intervention is crucial, with both voriconazole and itraconazole demonstrating positive treatment outcomes for Scedosporium boydii infection. Therefore, prioritizing these antifungal agents should be considered a key therapeutic strategy in the management of this patient population.

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侵袭性 Scedosporium boydii 感染的临床特征和抗真菌治疗：病例报告和文献综述。

研究目的本研究旨在介绍一例由Scedosporium boydii引起的顽固性霉菌瘤，并对文献进行系统性综述，以阐明此类患者的临床特征和抗真菌治疗方法：我们报告了一例 24 岁女性患者的病例，她十多年前因指甲穿刺导致右脚感染童贞癣菌。同时，我们在PubMed上进行了一次全面的文献综述，重点关注有文献记载的Scedosporium boydii感染病例，旨在提取相关的临床数据：结果：我们的分析表明，移植后、外伤、溺水、皮质类固醇用药和既往手术史是童贞壳孢子菌感染的主要风险因素。感染部位包括皮肤/骨骼组织、中枢神经系统和眼部。在已确定的 49 名患者中，24 人接受了伊曲康唑治疗，25 人接受了伏立康唑治疗，结果无显著差异（P = 0.158）。其中，12 名患者治疗失败。值得注意的是，延长抗真菌治疗持续时间被认为是抵御男孩盾孢子菌感染死亡率的保护因素[P = 0.022，OR(95%CI)：0.972(0.949-0.996)]。相反，移植后病史是导致死亡的潜在风险因素[P = 0.046，OR(95%CI)：7.017(1.034-47.636)]：结论：虽然并不常见，但波氏囊孢子菌感染会造成严重的发病率和不良后果。临床上需要对具有该病原体风险因素的患者提高警惕。及时、有效的抗真菌干预至关重要，伏立康唑和伊曲康唑对童贞壳孢子菌感染都有积极的治疗效果。因此，优先使用这些抗真菌药物应被视为治疗这类患者的关键治疗策略。

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来源期刊

Annals of Clinical Microbiology and Antimicrobials MICROBIOLOGY-

CiteScore

8.60

自引率

0.00%

发文量

审稿时长

>12 weeks

期刊介绍： Annals of Clinical Microbiology and Antimicrobials considers good quality, novel and international research of more than regional relevance. Research must include epidemiological and/or clinical information about isolates, and the journal covers the clinical microbiology of bacteria, viruses and fungi, as well as antimicrobial treatment of infectious diseases. Annals of Clinical Microbiology and Antimicrobials is an open access, peer-reviewed journal focusing on information concerning clinical microbiology, infectious diseases and antimicrobials. The management of infectious disease is dependent on correct diagnosis and appropriate antimicrobial treatment, and with this in mind, the journal aims to improve the communication between laboratory and clinical science in the field of clinical microbiology and antimicrobial treatment. Furthermore, the journal has no restrictions on space or access; this ensures that the journal can reach the widest possible audience.