Scedosporiosis/lomentosporiosis observational study (SOS): Clinical significance of <i>Scedosporium</i> species identification
Didier Brönnimann, Dea Garcia‐Hermoso, Françoise Dromer, Fanny Lanternier, The French Mycoses Study Group, Laurence Maulin, Yves Leprince, Nathalie Brieu, Bérengère Gruson, Youssef El-Samad, Taïeb Chouaki, S. Bayle, Cécile Jensen, S. Branger, Grégoire Leclerc, Laurent Hustache‐Mathieu, Fabrice Larosa, Frédéric Grenouillet, Diane Bouvry, F. Méchaï, Sophie Brun, Frédéric Villega, H. Dutronc, Jean-François Velly, Laurence Delhaès, Frédéric Gabriel, N. Paleiron, Laurence Di Costanzo Pougnet, A. de Tinteniac, Luc Quaesaet, Liana Carausu, Gaëlle Guillerm, Lénaïg Le Clech, Gilles Nevez, Julie Bonhomme, Cécile Moluçon‐Chabrot, Jacques‐Olivier Bay, Céline Nourrisson, Philippe Poirier, A. Lefort, Véronique Leflon‐Guibout, Catherine Cordonnier, Nicolas Limal, F. Botterel-Chartier, H Mondor, Philippe Zann, Benoît Rozé, N. Desbois, L. Escaut, Jean‐François Papon, A. Angoulvant, Kamel Laribi, Pascale Penn, Pascal Turlure, Thomas Daix, B. Melloni, Bernard Bouteille, Thomas Perpoint, Florence Ader, Marie Balsat, Florence Persat, Jean-Marie Forel, Valérie Moal, Stéphane Ranque, Cristina Audoly, Delphine Lancement, Caroline Fritz, Joséphine Dorin, Marie Machouart, David Boutoille, Jéremie Orain, Delphine Horeau-Langlard, Florent Morio, Olivier Moquet, Viviane Queyrel‐Moranne, Lionel Mannone, Pierre‐Marie Roger, M. Gari-Toussaint, Lilia Hasseine, Giovanna Ingenuo, Nicolas Dürrleman, Nina Arakelyan-Laboure, D.M. Poisson, Marine Paul, Frédéric Pène, A. Paugam, Valérie Zeller, B́eate Heym, R. Guillemain, Yoann Prevot, Éric Dannaoui, Pierre Frange, Stéphane Blanche, Felipe Suárez, Anne Scemla, Romain Guéry, Olivier Lortholary, Marie‐Elisabeth Bougnoux, Thomas Similowski, Eric Caumes
Abstract
Scedosporiosis/lomentosporiosis is a devastating emerging fungal infection. Our objective was to describe the clinical pattern and to analyze whether taxonomic grouping of the species involved was supported by differences in terms of clinical presentations or outcomes. We retrospectively studied cases of invasive scedosporiosis in France from 2005 through 2017 based on isolates characterized by polyphasic approach. We recorded 90 cases, mainly related to Scedosporium apiospermum (n = 48), S. boydii/S. ellipsoideum (n = 20), and Lomentospora prolificans (n = 14). One-third of infections were disseminated, with unexpectedly high rates of cerebral (41%) and cardiovascular (31%) involvement. In light of recent Scedosporium taxonomic revisions, we aimed to study the clinical significance of Scedosporium species identification and report for the first time contrasting clinical presentations between infections caused S. apiospermum, which were associated with malignancies and cutaneous involvement in disseminated infections, and infections caused by S. boydii, which were associated with solid organ transplantation, cerebral infections, fungemia, and early death. The clinical presentation of L. prolificans also differed from that of other species, involving more neutropenic patients, breakthrough infections, fungemia, and disseminated infections. Neutropenia, dissemination, and lack of antifungal prescription were all associated with 3-month mortality. Our data support the distinction between S. apiospermum and S. boydii and between L. prolificans and Scedosporium sp. Our results also underline the importance of the workup to assess dissemination, including cardiovascular system and brain.