Open forum infectious diseases · 2026
Endocarditis Due to Scedosporium spp and Lomentospora prolificans: Case Series and Literature Review.
СтатьяНазвание и аннотация: Перевод в очереди
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Vignals Carole, Ternacle Julien, Garcia-Hermoso Dea, Emmerich Joseph, Catherinot Emilie, Delhaes Laurence, Horeau-Langlard Delphine, Martellosio Jean-Philippe, Morio Florent, Lortholary Olivier, Puges Mathilde, Lanternier Fanny, Bronnimann Didier
Аннотация
BACKGROUND: Scedosporium spp and Lomentospora prolificans are rare fungi involved in mold endocarditis.
METHODS: We reported cases of Scedosporium spp and L prolificans endocarditis from the French Scedosporiosis/Lomentosporiosis Observational Study (S.O.S.) and performed a literature review of previous reported cases in order to describe their predisposing risk factors, clinical presentation, treatment, and outcomes.
RESULTS: We included 30 cases including 4 new cases from the S.O.S. Sixty percent (18/30) of the cases were due to Scedosporium apiospermum complex and 37% (11/30) to L prolificans. Trauma was the main invasive fungal disease host factor (12/30 [40%]), followed by solid organ transplant (10/30 [33%]), short posttransplant delay (median of 45 days), and malignancy (5/30 [17%]). No endocarditis predisposing condition was found in immunocompromised patients (0/16). Eleven cases were healthcare-associated infections (37%). Septic emboli were reported in 93% of the cases (28/30), affecting mainly the central nervous system (CNS) (68%). Pulmonary emboli were present in all right-sided endocarditis (8/8). Blood cultures were negative in 6 cases (27% [6/26]). Surgical valve replacement was performed in 50% of the cases (8/16). Mortality was high whether patients were treated with antifungals only (7/8 [88%]) or with antifungals and surgery (5/7 [71%]). Mortality rose to 100% in the case of CNS emboli.
CONCLUSIONS: Scedosporium spp and L prolificans endocarditis is a life-threatening fungal disease occurring in both immunocompromised and immunocompetent hosts. It should be considered in the presence of fungemia or embolic complications, particularly in the CNS.
METHODS: We reported cases of Scedosporium spp and L prolificans endocarditis from the French Scedosporiosis/Lomentosporiosis Observational Study (S.O.S.) and performed a literature review of previous reported cases in order to describe their predisposing risk factors, clinical presentation, treatment, and outcomes.
RESULTS: We included 30 cases including 4 new cases from the S.O.S. Sixty percent (18/30) of the cases were due to Scedosporium apiospermum complex and 37% (11/30) to L prolificans. Trauma was the main invasive fungal disease host factor (12/30 [40%]), followed by solid organ transplant (10/30 [33%]), short posttransplant delay (median of 45 days), and malignancy (5/30 [17%]). No endocarditis predisposing condition was found in immunocompromised patients (0/16). Eleven cases were healthcare-associated infections (37%). Septic emboli were reported in 93% of the cases (28/30), affecting mainly the central nervous system (CNS) (68%). Pulmonary emboli were present in all right-sided endocarditis (8/8). Blood cultures were negative in 6 cases (27% [6/26]). Surgical valve replacement was performed in 50% of the cases (8/16). Mortality was high whether patients were treated with antifungals only (7/8 [88%]) or with antifungals and surgery (5/7 [71%]). Mortality rose to 100% in the case of CNS emboli.
CONCLUSIONS: Scedosporium spp and L prolificans endocarditis is a life-threatening fungal disease occurring in both immunocompromised and immunocompetent hosts. It should be considered in the presence of fungemia or embolic complications, particularly in the CNS.