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

Summary

This study examined eight elderly patients without compromised immune systems who had the fungus Scedosporium detected in their lungs. All patients had a condition called bronchiectasis, and most had previously suffered from MAC disease. The researchers found that in most cases, the fungus was just colonizing the lungs without causing active infection. The challenge for doctors is determining whether Scedosporium is simply living in the lungs or actively causing disease.

Background

Scedosporium is a filamentous fungus that typically infects immunocompromised individuals but can occasionally affect immunocompetent people, particularly those with underlying lung conditions. The optimal management of immunocompetent patients with Scedosporium detected in respiratory samples remains poorly understood.

Objective

This study aimed to characterize the clinical features of immunocompetent patients with Scedosporium detected in respiratory specimens and to understand the distinction between colonization and true infection.

Results

Eight elderly immunocompetent female patients were identified, all with bronchiectasis on chest imaging and seven with a history of pulmonary MAC disease. Seven patients were classified as having colonization while one had infection. The colonized patient with infection was treated with voriconazole with clinical stabilization but without negative sputum culture conversion.

Conclusion

Bronchiectasis, particularly linked with pulmonary MAC disease, may be an important underlying condition for Scedosporium colonization or infection in immunocompetent individuals. In the majority of cases, Scedosporium represents colonization, though distinguishing between colonization and infection remains a critical clinical challenge.
  • Published in:Respiratory Medicine Case Reports,
  • Study Type:Case Series,
  • Source: PMID: 40688721, DOI: 10.1016/j.rmcr.2025.102256
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