Endocarditis caused by Scopulariopsis brevicaulis with disseminated emboli and multiple vascular aneurysms: A case report and literature review.

BACKGROUND

Scopulariopsis brevicaulis, a saprophytic fungus often associated with onychomycosis, has seldom been reported to cause deep-tissue infections in immunocompromised patients.

OBJECTIVES

To review the antifungal susceptibility of S. brevicaulis and management strategies for related endocarditis and other invasive infections.

SOURCES: A literature search was conducted using PubMed until September 2024.

CONTENT: This review presents a case of S. brevicaulis prosthetic valve endocarditis, emphasizing the diagnostic challenges and clinical implications of disseminated infection.A summary of published cases of endocarditis and other deep-tissue infections is included along with a discussion on the antifungal susceptibility of S. brevicaulis and current treatment strategies.

IMPLICATIONS: S. brevicaulis presents a significant treatment challenge due to its rare and opportunistic nature, along with frequent multi-drug resistance. Although there is no single optimal therapy for this mold, a practical approach combines medical and surgical strategies customized to individual cases, employing a variety of agents based on in vitro sensitivity testing. Determining minimum inhibitory concentrations (MICs) is essential for guiding treatment decisions, even in the absence of established clinical breakpoints for this pathogen. Olorofilm, a novel oral antifungal, demonstrates remarkable potential for treating S. brevicaulis.