Pseudallescheriasis in the 21st century

• Published in: Expert review of anti-infective therapy Vol. 3; no. 5; pp. 765 - 773
• Main Author: O'Bryan, Thomas A
• Format: Journal Article
• Language: English
• Published: England Taylor & Francis 01.10.2005; Informa Healthcare
• Subjects: Animals; Antifungal Agents - pharmacology; Antifungal Agents - therapeutic use; emerging; Humans; immunocompromised; Mycetoma - drug therapy; Mycetoma - pathology; mycosis; Opportunistic Infections - drug therapy; Opportunistic Infections - microbiology; Opportunistic Infections - pathology; Pseudallescheria - drug effects; Pseudallescheria - pathogenicity; Pseudallescheria - physiology; Pseudallescheria boydii; pseudallescheriasis; Scedosporium apiospermum; treatment; voriconazole
• ISSN: 1478-7210; 1744-8336
• DOI: 10.1586/14787210.3.5.765

Since its discovery as an agent of mycetoma nearly a century ago, Pseudallescheria boydii with its asexual (synanamorphic) form, Scedosporium apiospermum, is now recognized as an important emerging opportunistic pathogen causing invasive mycosis in immunocompromised patients. The clinical spectrum of pseudallescheriasis is wide. Invasive disease of the lung, CNS and dissemination are serious manifestations in immunocompromised patients. This organism responds poorly to amphotericin B, and its histopathologic resemblance to aspergillosis often results in a delay in diagnosis. In vitro data, animal models and accumulating clinical experience support the use of voriconazole as a primary treatment for pseudallescheriasis. This paper reviews the microbiology, ecology, epidemiologic trends, clinical manifestations and current treatment options of pseudallescheriasis.