Scedosporium species and Lomentospora prolificans fungaemia is uniformly fatal in patients with haematological malignancy

Scedosporium and Lomentospora species are environmental moulds that are virulent in immunocompromised hosts and rarely cause bloodstream infection (BSI). Patients with Scedosporium and Lomentospora species BSI were identified by the state public laboratory service in Queensland, Australia, over a 20-year period. Twenty-two incident episodes occurred among 21 residents; one patient had a second episode 321 days following the first. Of these, 18 were Lomentospora prolificans, three were Scedosporium apiospermum complex and one was a nonspeciated Scedosporium species. Seventeen (81%) patients died during their index admission, and all-cause mortality at 30, 90 and 365 days was 73%, 82% and 91% respectively. All 20 patients with haematological malignancy died within 365 days of follow-up with a median time to death of 9 days (interquartile range, 6-20 days) following diagnoses of BSI.

Automated summary

A 20-year study in Queensland, Australia, found that Scedosporium and Lomentospora species, which are environmental moulds, rarely cause bloodstream infection in immunocompromised hosts. Among 22 incident episodes of Scedosporium and Lomentospora species bloodstream infection, 18 were caused by Lomentospora prolificans, 3 by Scedosporium apiospermum complex, and 1 by a nonspeciated Scedosporium species. The overall mortality rate for these patients was high, with 81% dying during their index admission and all-cause mortality at 30, 90, and 365 days being 73%, 82%, and 91% respectively. In addition, all 20 patients with haematological malignancy died within 365 days of follow-up, with a median time to death of 9 days following the diagnosis of bloodstream infection.