Scedosporium apiospermum pneumonia and sternal wound infection in a heart transplant recipient

Background. The most common fungi that cause invasive infection in transplant recipients are the Aspergillus spp, Candida spp, Cryptococcus neoformans, and the endemic fungi such as Histoplasma capsulatum and Coccidioides immitis. Recently, however, other fungal pathogens have emerged as important causes of invasive disease in these immunocompromised individuals, including the dematiaceous fungi, such as Alternaria and the Exophiala spp, species of Trichosporon and Fusarium, and the hyalohyphomycoses, such as Scedosporium apiospermum (Pseudallescheria boydii) (1). Methods. We present a single patient case report and literature review. Results. We illustrate the first reported case of a postoperative sternal wound infection and pneumonia caused by S. apiospermum in a heart transplant recipient and review the significant clinical, microbiologic, and therapeutic aspects of infection with this important opportunistic pathogen. Conclusions. Postsurgical wound infection should be added to the growing list of infections in the transplant population caused by S. apiospermum.