Clinical characterization of immunocompetent patients with Scedosporium detected in respiratory samples: A case series

Author: mycolabadmin
7/7/2025
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Summary

This study examined eight elderly patients without compromised immune systems who had Scedosporium fungus detected in their lungs. All patients had a condition called bronchiectasis and most had previously suffered from a lung infection called MAC disease. The researchers found that in most cases, the fungus was simply living in the lungs without causing active infection, though distinguishing between these two situations proved difficult. Only one patient was diagnosed with an active Scedosporium infection and required antifungal treatment with a drug called voriconazole.

Background

Scedosporium is a filamentous fungus that primarily infects immunocompromised individuals but can occasionally infect immunocompetent people, particularly those with underlying lung conditions. The optimal management of Scedosporium detection in immunocompetent patients remains poorly understood, and distinguishing between colonization and true infection presents a significant clinical challenge.

Objective

To characterize the clinical features, underlying conditions, and outcomes of immunocompetent patients with Scedosporium detected in respiratory specimens, with particular emphasis on differentiating colonization from infection.

Results

Eight elderly immunocompetent female patients were identified, all with bronchiectasis on chest imaging and seven with history of pulmonary MAC disease. Seven patients (87.5%) were classified as having colonization, while one was diagnosed with infection caused by Scedosporium apiospermum. The colonization cases had spontaneous negative conversion or resolved with MAC treatment, while the infection case showed persistent positivity despite voriconazole treatment.

Conclusion

Bronchiectasis, particularly when associated with pulmonary MAC disease, is a significant underlying condition for Scedosporium colonization or infection in immunocompetent individuals. Scedosporium in respiratory samples of immunocompetent patients predominantly represents colonization, but distinguishing colonization from infection remains a critical clinical challenge requiring careful longitudinal follow-up.

Published in:Respiratory Medicine Case Reports,
Study Type:Case Series,
Source: PMID: 40688721, DOI: 10.1016/j.rmcr.2025.102256