Scedosporium species complex: The hidden and overlooked danger
Keywords:
Scedosporium spp, Lomentospora spp, Scedosporiosis, Lomentosporiosis, near-drowningAbstract
Scedosporiosis and Lomentosporiosis are fungal infections caused by species within the Scedosporium spp. and Lomentospora prolificans. These pathogens are notably resistant to multiple antifungal agents, with resistance rates exceeding 85%. Despite the severity of these infections, reports in Thailand remain limited, contrasting with global trends. This discrepancy may be due to diagnostic challenges, as these fungi closely resemble Aspergillus spp. in both clinical presentation and pathological features. While infections caused by these fungi are relatively rare, the mortality rate is alarmingly high, exceeding 75%. Individuals with compromised immune systems, such as cancer patients, organ transplant recipients, or those living with HIV/AIDS, are at the highest risk. However, infections have also been observed in immunocompetent individuals, especially those with a history of aspiration of contaminated water or injuries involving sharp objects. Additionally, these fungi are more commonly found in densely populated urban areas than in rural or forested regions, as they increasingly integrate into human environments. In Thailand, healthcare professionals have had limited exposure to these pathogens, with significant awareness emerging only after 2007, following reports of fatalities. In 2022, the World Health Organization (WHO) recognized the public health significance of these pathogens by classifying them within the medium priority group of the WHO Fungal Priority Pathogen List (FPPL). This classification highlights the urgent need for further research. This article aims to provide foundational knowledge on these human-pathogenic fungi, including historical patient cases, contamination reports in Thailand, clinical characteristics, laboratory diagnostic methods, and current antifungal treatments, to pave the way for future research and advancements in this critical area.
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