Life-threatening airway stenosis due to Scedosporium infection during nontuberculous mycobacteria treatment: A case report.

Fungal pathogens generally grow in the pulmonary parenchyma, but occasionally involve the bronchial wall. A 73-year-old female was admitted to our hospital with dyspnea and a critical endobronchial fungal infection. Because the central airway stenosis was life-threatening, a silicone stent was inserted into the trachea on an urgent basis under extracorporeal membrane oxygenation. We identified the pathogen as Scedosporium apiospermum. Treatment with voriconazole gradually improved the endobronchial lesion, and the stent was extubated 6 months later. Although pulmonary infection of Scedosporium spp. is rare, the comorbidity of rheumatoid arthritis with immunosuppressive treatment and pre-existing cavitary lesion induced by Mycobacterium avium-infection were considered to be risk factors for more extensive lesion development. Urgent endobronchial intervention and appropriate fungal treatment can provide successful outcomes in patients with fulminant endobronchial infection.