Thread by @IUIDfellowship

#idboardreview 60 F RA on chronic steroids presents w/ progressive R wrist pain/swelling s/p I&D, progressively worse erythema spreading up the arm. Tendon micro+small gray colonies & thin, septate hyphae branching at acute angles. Diagnosis? #medEd #idmeded #idtwitter

#scedosporium apiospermum is the anamorph or asexual form of #Pseudallescheria boydii. Usual sites of infection include CNS, eyes, lungs, sinuses, bones, joints, and soft tissues jcm.asm.org/content/43/2/9…

#scedosporium Fast growing, greyish-white colonies suede-like to downy w/ greyish-black reverse. Numerous single-celled, pale-brown, broadly clavate to ovoid conidia, 4-9 x 6-10 µm, rounded above w/ truncate bases are observed mycology.adelaide.edu.au/descriptions/h…

cmr.asm.org/content/21/1/1… #scedosporium

CNS or sino-pulmonary infection after 'near-drowning' #scedosporium nejm.org/doi/10.1056/NE…

#scedosporium #mycetoma infection atsjournals.org/doi/full/10.15…

#scedosporium typically occurs in immunocompromised individuals or post trauma
-CNS infection in immunocompetent post near-drowing
-Found in soil, fresh water especially stagnant or polluted water

#scedosporium apiospermum is the most commont sp infecting humans. Identification typically by DNA sequencing. Dx: culture recovering from infected site. Because airway may be colonized, sputum cultures may not reflect infection

#scedosporium voriconazole likely the most effective agent

#scedosporium #prolificans disseminated (severely immunosuppressed)), B&J infection. May cause onychomycosis & infections of eye/wounds. Localized infections in immunocompetent post trauma. Organism in soil and can colonize respiratory tract. No effective tx. Consider vori+ampho

mold infections of CNS @NEJM #idtwitter nejm.org/doi/10.1056/NE…