Successful treatment of disseminated scedosporium infection in 2 lung transplant recipients: review of the literature and recommendations for management.

Scedosporium species (sp) can cause disseminated disease in lung transplant recipients with almost universal mortality. We present 2 cases of disseminated disease, which responded to voriconazole therapy. In the first case, polymerase chain reaction was used to make a rapid diagnosis and allow differentiation from Aspergillus sp. In this patient, Scedosporium sp could be isolated in the urine despite therapy, and direct irrigation of the renal tract with voriconazole was used with apparent efficacy. In the other case, withdrawal of therapy resulted in clinical relapse, suggesting that lifelong therapy is probably required.