What are the other Names for this Condition? (Also known as/Synonyms)

• Hyalohyphomycosis Fungal Infection
• Hyalohyphomycotic Fungal Infection
• Infection by Scedosporium Sp.

What is Scedosporium Infection? (Definition/Background Information)

• Scedosporium is a microscopic organism belonging to a class of fungus called ‘hyalohyphomycosis’. Scedosporium Infection is considered to be an emerging fungal infection. It can occur as an opportunistic and life-threatening infection in individuals with weakened immune systems
• The most common method of entry of the Scedosporium fungus into the body is through open cuts or wounds. It can cause an infection anywhere in the body
• The signs and symptoms associated with Scedosporium Infection are generally based upon the nature of the infection - whether it is localized or disseminated. The disseminated form can cause severe complications affecting even the lungs and brain
• Treatment of this fungal infection depends upon the type of infection and health condition of the affected individual. Generally, healthy individuals with localised form of infection respond to treatment better than individuals with immunocompromised state and systemic disease
• With correct diagnosis and appropriate treatment, localised Scedosporium Infection has excellent prognosis. However, the prognosis of disseminated form depends upon the health status of the individual and the infection severity

Who gets Scedosporium Infection? (Age and sex Distribution)

• Scedosporium Infection can affect any individual irrespective of age, gender, and race
• However, individuals with weak immune systems have a higher risk of infection

What are the Risk Factors for Scedosporium Infection? (Predisposing Factors)

The risk factors for Scedosporium Infection include:

• Individuals with weak immune system
• Those who have had a bone marrow transplant or solid organ transplant
• Individuals undergoing chemotherapy for cancer treatment
• HIV-infected and AIDS-affected individuals

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Scedosporium Infection? (Etiology)

• Scedosporium Infection is an opportunistic fungal infection caused by the molds of hyalohyphomycotics, a group of fungi. It is a relatively recently discovered infection
• The most common subtype of Scedosporium causing the infection is S. apispermum
• The fungus is found in soils, contaminated waters, and the manure of cattle and domesticated birds (such as chicken and ducks)
• An infection occurs in humans when the fungus enters the body through the skin after a trauma that penetrates the skin. This is the most common method of transmission
• Other methods by which the fungus enters the body includes drinking contaminated water, eating contaminated food, of inhaling the fungal spores

What are the Signs and Symptoms of Scedosporium Infection?

Scedosporium Infection can cause infection anywhere in the body. The infection can be localized or disseminated.

• Localized infection usually occurs in individuals with generally healthy immune system and is generally confined to a body area or organ
• A disseminated infection occurs in immunocompromised individuals and may affect any part of the body. It is generally more severe than a localized form of infection

Localized infections may affect the following body regions and cause:

• Infection of the ear (otitis)
• Infection of the nasal cavity (sinusitis)
• Infection of the soft tissue (cellulitis)
• Infection of bone (osteomyelitis)

If disseminated infection occurs, it can cause the following conditions:

• Lung infection (pneumonia)
• Infection of the meninges (meningitis)
• Infection of the brain (encephalitis)

The signs and symptoms of Scedosporium Infection depend upon the body region or system affected.

How is Scedosporium Infection Diagnosed?

Since Scedosporium Infection is not a common condition, the healthcare provider must keep this condition in mind during evaluation of the individual. The diagnosis may involve:

• A complete evaluation of medical history along with a thorough physical exam
• Blood tests and blood cultures
• Fungal cultures
• Imaging studies depending on the region affected
• Molecular methods: It can help confirm the type and species of fungus causing the infection
• Other tests based on the underlying signs and symptoms (as necessary)
• Tissue biopsy: A tissue biopsy is performed and sent to a laboratory for a pathological examination. The pathologist examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis

Note: When the pathologist examines the tissue sample under a microscope, he/she may see the presence of necrotizing granulomas.

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Scedosporium Infection?

The following are the complications associated with Scedosporium Infection:

• Severe meningitis (inflammation of the protective membranes covering the brain and spinal cord)
• Severe pneumonia
• Spread of infection: When the infection spreads from the lungs to the bloodstream and to the brain, heart, kidneys, and skin, it can become fatal and life-threatening. This condition is more dangerous in individuals with poor immune system

How is Scedosporium Infection Treated?

The following are the treatment measures adopted for Scedosporium Infection; the treatment also depends upon the nature and form of infection.

• Oral corticosteroids
• Antifungal medications
• Treatment of the underlying condition causing a poor immune system
• Complete bed rest
• Improved nutrition and overall health status

How can Scedosporium Infection be Prevented?

It may not be possible to completely avoid the Scedosporium fungus, due to their worldwide distribution. Nevertheless, some safety and precautionary measures may help in preventing Scedosporium Infection. These include:

• Avoid exposure to the Scedosporium fungus: Individuals (especially those with a weakened immune system) should avoid areas where the fungus grow and thrive, such as soils and contaminated water bodies
• Extensive activities involving soil and dust should be minimised or avoided
• Avoid handling the excreta of domesticated animals (cattle) and birds
• Skin injuries must be cleaned well with soap and water
• Do not consume any contaminated food or liquids (or water)
• Educate people about the risk factors and adverse health effects of Scedosporium, which can help them become aware of the fungus

A good hygiene and healthy lifestyle improves the body immune system against infections such as caused by Scedosporium.

What is the Prognosis of Scedosporium Infection? (Outcomes/Resolutions)

• The prognosis of localized form of Scedosporium Infection in healthy individuals with appropriate treatment is excellent
• The prognosis of disseminated form of Scedosporium Infection depends upon the overall health of the individual and severity of infection
• A lack of proper treatment, poor health status of the individual, and the presence of severe complications, are all factors that may affect the prognosis adversely. In such circumstances, the infection can even be fatal

Additional and Relevant Useful Information for Scedosporium Infection:

Apart from S. apiospermum, S. prolificans is another fungus belonging to the Scedosporium species that can cause the infection. It mostly infects children and young adults.