Abstract Background Scedosporium spp and Lomentospora prolificans are rare fungi involved in mold endocarditis. Methods We reported cases of Scedosporium spp and L prolificans endocarditis from the French Scedosporiosis/Lomentosporiosis Observational Study (S.O.S.) and performed a literature review of previous reported cases in order to describe their predisposing risk factors, clinical presentation, treatment, and outcomes. Results We included 30 cases including 4 new cases from the S.O.S. Sixty percent (18/30) of the cases were due to Scedosporium apiospermum complex and 37% (11/30) to L prolificans. Trauma was the main invasive fungal disease host factor (12/30 40%), followed by solid organ transplant (10/30 33%), short posttransplant delay (median of 45 days), and malignancy (5/30 17%). No endocarditis predisposing condition was found in immunocompromised patients (0/16). Eleven cases were healthcare-associated infections (37%). Septic emboli were reported in 93% of the cases (28/30), affecting mainly the central nervous system (CNS) (68%). Pulmonary emboli were present in all right-sided endocarditis (8/8). Blood cultures were negative in 6 cases (27% 6/26). Surgical valve replacement was performed in 50% of the cases (8/16). Mortality was high whether patients were treated with antifungals only (7/8 88%) or with antifungals and surgery (5/7 71%). Mortality rose to 100% in the case of CNS emboli. Conclusions Scedosporium spp and L prolificans endocarditis is a life-threatening fungal disease occurring in both immunocompromised and immunocompetent hosts. It should be considered in the presence of fungemia or embolic complications, particularly in the CNS.
Vignals et al. (Thu,) studied this question.