Short Report
Scedosporium prolificans endogenous endophthalmitis

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Scedosporium prolificans is an opportunistic fungus with a predilection for sepsis and endophthalmitis in immunocompromised patients. We report a case of endogenous S. prolificans endophthalmitis in a 9-year-old girl following chemotherapy for acute myeloid leukemia. She achieved an excellent visual outcome following intensive antifungal therapy.

Section snippets

Case Report

A 9-year-old Chinese girl with acute myeloid leukemia (AML) who was undergoing chemotherapy at the Royal Children's Hospital in Melbourne, Australia, since August 2006 suffered an episode of febrile neutropenia after the first two cycles. She recovered uneventfully. The third cycle of chemotherapy (cytarabine and etoposide), in November 2006, was again complicated by febrile neutropenia. Her white cell count was 0.1 × 109/L, with no neutrophils seen on blood film. Initial blood cultures grew

Discussion

Scedosporium fungi are found in soil and multiple water sources. S. prolificans can cause progressive infection and immunocompromised individuals are susceptible to endopthalmitis.1 The optimal treatment for S. prolificans is not well established. Scedosporium is relatively resistant to amphotericin B, nystatin, fluconazole, itraconazole, 5-flucytosine, and echinocandin.2 Newer antifungals such as caspofungin, voriconazole, and terbinafine are more effective, and terbinafine and voriconazole

Literature Search

The PubMed database was searched, without language or date restrictions, using the following terms: (scedosporium [MeSH Terms] OR scedosporium [All Fields]) AND (miltefosine [Supplementary Concept] OR miltefosine [All Fields]). Manual search of the reference lists of relevant publications was also performed; however, no further articles were found.

References (10)

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    Median observation time and treatment duration were calculated using median and interquartile ranges (IQR). Fifty-five pediatric patients (17 girls, 38 boys) with invasive Scedosporium spp. (n = 33, 60%) or L. prolificans (n = 22, 40%) infection reported since 1990 were identified in the literature (n = 44) and FungiScope® (n = 11, two published (Holle et al., 2014; Jover-Saenz et al., 2016)) (Abzug and Walsh, 2004; Acharya et al., 2006; Barbaric and Shaw, 2001; Bhagavatula et al., 2014; Bonduel et al., 2001; Chakraborty et al., 2005; Chen et al., 2014; Chiam et al., 2013; Cruysmans et al., 2015; Dalton et al., 2006; Gatto et al., 1997; Gompels et al., 2002; Hachimi-Idrissi et al., 1990; Hell et al., 2011; Holle et al., 2014; Jabado et al., 1998; Jover-Saenz et al., 2016; Kesson et al., 2009; Klopfenstein et al., 2003; Lee et al., 2018; Madrigal et al., 1995; Marques et al., 2011; Matlani et al., 2013; Messori et al., 2002; Mursch et al., 2006; Nielsen et al., 1993; Penteado et al., 2018; Pickles et al., 1996; Romero Gomez and Garcia Rodriguez, 2010; Ruchel and Wilichowski, 1995; Slack et al., 1999; Sobottka et al., 1999; Song et al., 2011; Sparrow et al., 1992; Steinbach et al., 2003; Stripeli et al., 2009; Studahl et al., 2003; Sydnor et al., 2003; Tapia et al., 1994; Vazquez-Tsuji et al., 2006; Whyte et al., 2005; Wilichowski et al., 1996; Wood et al., 1992; Zarkovic and Guest, 2007). Cases were reported from 21 countries without evidence for endemic occurrence of the infection (Europe [n = 26], North America [n = 8], South America [n = 4], Asia [n = 5], Oceania [n = 12]) (Supplementary Figure S2).

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