Life-threatening airway stenosis due to Scedosporium infection during nontuberculous mycobacteria treatment: A case report
- Author: mycolabadmin
- 10/20/2025
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Summary
A 73-year-old woman with arthritis being treated with immunosuppressive drugs developed a severe fungal airway infection caused by a rare fungus called Scedosporium apiospermum. Her airway became dangerously narrowed, requiring emergency support with an artificial lung machine while doctors inserted a stent to open her airway. After correctly identifying the fungus and treating it with an antifungal medication called voriconazole, she recovered well with complete healing of the infection.
Background
Endobronchial fungal infections are uncommon, with Aspergillus spp. being the most frequently reported causative organism. A 73-year-old female with rheumatoid arthritis under immunosuppressive therapy and chronic Mycobacterium avium complex (MAC) infection presented with life-threatening tracheal stenosis.
Objective
To report a case of life-threatening airway stenosis caused by endobronchial Scedosporium apiospermum infection and describe the urgent management and treatment approach used.
Results
The pathogen was identified as Scedosporium apiospermum. After switching from amphotericin B to voriconazole with therapeutic drug monitoring (target trough 1-4 μg/L), the infection gradually improved. The silicone stent was successfully removed 6 months after initial placement with complete resolution of fungal infection and no post-inflammatory stenosis.
Conclusion
Urgent endobronchial intervention combined with appropriate antifungal therapy and stent placement can provide successful outcomes in life-threatening endobronchial fungal infections. Accurate pathogen identification is critical for selecting effective antifungal agents, particularly when distinguishing Scedosporium from Aspergillus species.
- Published in:Respiratory Medicine Case Reports,
- Study Type:Case Report,
- Source: PMID: 41210149, DOI: 10.1016/j.rmcr.2025.102309