Epidemiology of Scedosporiosis

Abstract

Infections due to Scedosporium/Pseudallescheria species are increasingly recognized in both immunocompromised and immunocompetent hosts. Patients with organ and stem cell transplants and malignancy are at high risk for infection. Infection is also acquired through trauma and near-drowning incidents. Scedosporium apiospermum complex and Lomentospora prolificans (previously Scedosporium prolificans) account for most infections. Increasing use of sequencing-based molecular tools to identify these fungi has enabled better understanding of species-specific differences in geographical distribution, clinical epidemiology and presentation. S. apiospermum complex infections occur worldwide, affect diverse host groups and has protean clinical manifestations. L. prolificans typically causes infection in immunocompromised patients and is associated with disseminated infection and high mortality. S. aurantiacum (a member of S. apiospermum complex) has a propensity to be isolated from patients with cystic fibrosis and other chronic lung disease. Case clusters of L. prolificans infection have occurred. Appreciation of epidemiology is important to inform rapid diagnostics and antifungal therapy.