FATAL SCEDOSPORIUM-PROLIFICANS INFECTION IN A LEUKEMIC PATIENT

The case is described of a 42-year-old patient with acute myeloid leuk emia who received two courses of chemotherapy complicated by prolonged bone marrow depression. He was admitted to hospital with fever, hepat osplenomegaly and bilateral nodular pulmonary infiltrates. After admis sion diffuse cutaneous skin nodules, and hypodense lesions in the hemi spheres and cerebellum developed. Cultures of cerebrospinal fluid, bro nchoalveolar lavage fluid, skin biopsy specimens and blood revealed Sc edosporium prolificans, indicative of disseminated mycosis. Treatment with amphotericin B and fluconazole was unsuccessful and the patient d ied within five days after admission. Features that may enhance early recognition of Scedosporium prolificans infection by both clinicians a nd microbiologists, as well as options in the treatment of infection w ith this fungal agent are discussed.