Case report: Disseminated Scedosporium apiospermum infection with invasive right atrial mass in a heart transplant patient

Baudouin Bourlond; Ana Cipriano; Julien Regamey; Matthaios Papadimitriou-Olivgeris; Christel Kamani; Danila Seidel; Frederic Lamoth; Olivier Muller; Patrick Yerly

doi:10.3389/fcvm.2022.1045353

Case report: Disseminated Scedosporium apiospermum infection with invasive right atrial mass in a heart transplant patient

Front Cardiovasc Med. 2022 Oct 31:9:1045353. doi: 10.3389/fcvm.2022.1045353. eCollection 2022.

Authors

Baudouin Bourlond¹, Ana Cipriano², Julien Regamey¹, Matthaios Papadimitriou-Olivgeris², Christel Kamani^{1

3}, Danila Seidel^{4

5

6

7}, Frederic Lamoth^{2

8}, Olivier Muller¹, Patrick Yerly¹

Affiliations

¹ Department of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
² Infectious Diseases Service, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
³ Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
⁴ Department I of Internal Medicine, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany.
⁵ Center for Integrated Oncology Aachen Bonn Cologne Dusseldorf (CIO ABCD), University of Cologne, Cologne, Germany.
⁶ Excellence Center for Medical Mycology (ECMM), University of Cologne, Cologne, Germany.
⁷ Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany.
⁸ Department of Laboratories, Institute of Microbiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.

Abstract

Scedosporium apiospermum associated endocarditis is extremely rare. We report a case of a disseminated S. apiospermum infection with an invasive right atrial mass in a 52-year-old male, 11 months after heart transplantation, referred to our institution for an endogenous endophthalmitis with a one-month history of diffuse myalgias and fatigue. The patient had been supported two times with extracorporeal membrane oxygenation (ECMO) during the first three postoperative months. The echocardiography on admission revealed a mass in the right atrium attached to a thickened lateral wall. The whole-body [¹⁸F]FDG PET/CT revealed systemic dissemination in the lungs, muscles, and subcutaneous tissue. Blood cultures were positive on day three for filamentous fungi later identified as S. apiospermum. The disease was refractory to a 3-week dual antifungal therapy with voriconazole and anidulafungin in addition to reduced immunosuppression, and palliative care was implemented.

Keywords: Lomentospora prolificans; PET/CT; Scedosporium apiospermum; heart failure; heart tranplantation; infective endocarditis; mycoses.

Publication types

Case Reports

Grants and funding

Open access funding was provided by the University of Lausanne.