What are the other Names for this Condition? (Also known as/Synonyms)

• Cutaneous Scedosporium Infection
• Hyalohyphomycotic Fungal Infection of Skin
• Skin Infection by Scedosporium Sp.

What is Scedosporium Infection of Skin? (Definition/Background Information)

• Scedosporium is a microscopic organism belonging to a class of fungus called ‘hyalohyphomycosis’. Scedosporium Infection of Skin is an emerging infection that occurs as an opportunistic infection, mostly in individuals with weakened immune systems
• The most common method of entry of Scedosporium fungus into the body is through open cuts or wounds. It can cause a skin infection anywhere in the body
• Scedosporium Infection of Skin manifests as painful nodules or plaques at any location on the body. The nodules may be filled with pus and can bleed and ulcerate, resulting in superimposed infections and scarring on healing of the skin ulcers
• Generally, healthy individuals respond to treatment better than individuals with immunocompromised state. The treatment of Scedosporium Infection of Skin may involve the use of antifungal topical creams and oral medications
• With correct diagnosis and appropriate treatment, Scedosporium Infection of Skin has a excellent prognosis. However, the prognosis of the infection also depends upon the health status of the individual (any underlying conditions) and infection severity

Who gets Scedosporium Infection of Skin? (Age and sex Distribution)

• Scedosporium Infection of Skin can affect any individual irrespective of age, gender, and race
• However, individuals with weak immune systems have a higher risk of infection

What are the Risk Factors for Scedosporium Infection of Skin? (Predisposing Factors)

The risk factors for Scedosporium Infection of Skin include:

• Individuals with weak immune system
• Those who have had a bone marrow transplant or solid organ transplant
• Individuals undergoing chemotherapy for cancer treatment
• HIV-infected and AIDS-affected individuals
• Those who are exposed to environments with Scedosporium species

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Scedosporium Infection of Skin? (Etiology)

• Scedosporium Infection of Skin is an opportunistic fungal infection caused by the molds of hyalohyphomycotics, a group of fungi. It is an infection identified relatively recently
• The most common subtypes of Scedosporium causing the infection are S. apispermum and S. prolificans
• The fungus is found in soils, contaminated waters, and the manure of cattle and domesticated birds (such as chicken and ducks)
• An infection occurs in humans when the fungus enters the body through the skin after a trauma that penetrates the skin. This is the most common method of transmission
• Other methods by which the fungus enters the body includes drinking contaminated water, eating contaminated food, or inhaling the fungal spores
• Near-drowning in contaminated water is a source of possible encephalitis (brain) infection with Scedosporium

What are the Signs and Symptoms of Scedosporium Infection of Skin?

Scedosporium Infection of Skin can cause infection on the skin anywhere in the body.

• In individuals with generally healthy immune system, the infection is confined to a body site or location on the skin (localized infection)
• In immunocompromised individuals, it may affect several areas on the body (widespread infection). It is generally more severe than a localized form of infection

The signs and symptoms of Scedosporium Infection of Skin may include:

• The presence of pustules, nodules, or plaques at any location on the body
• The skin lesions are usually painful (painful to  touch)
• The nodules may be pus-filled
• Sometimes, severe pain and bleeding with ulceration of the skin nodules may occur

How is Scedosporium Infection of Skin Diagnosed?

Scedosporium Infection of Skin is not a common condition; hence, the healthcare provider must keep this in mind during evaluation of the individual. The diagnosis may involve:

• A complete evaluation of medical history along with a thorough physical exam
• Blood tests and blood cultures
• Fungal cultures, with sensitivity testing to antifungal medications 
• Molecular (PCR, DNA sequencing, and mass spectroscopy) methods: It can help confirm the type and species of fungus causing the infection
• Other tests based on the underlying signs and symptoms (as necessary)
• Skin biopsy: A skin biopsy is performed and sent to a laboratory for a pathological examination. The pathologist examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis

Note: When the pathologist examines the skin tissue sample under a microscope, he/she may see the presence of necrotizing granulomas.

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Scedosporium Infection of Skin?

The following are the complications associated with Scedosporium Infection of Skin:

• Localized skin infection can lead to the development of widespread disease or disseminated form of Scedosporium Infection
• Bleeding and ulceration can cause infection due to bacteria or additional fungi
• The skin infection may result in the formation of permanent fistulas (abnormal connection between tissues or organs, etc.)
• Scarring of skin on healing of the ulcerated lesions
• Spread of infection: When the infection spreads to the bloodstream and to the brain, heart, and kidneys, it can become fatal and life-threatening. This condition is more dangerous in individuals with poor immune system

How is Scedosporium Infection of Skin Treated?

The following are the treatment measures adopted for Scedosporium Infection of Skin.

• Antifungal topical applications and medications
• Oral corticosteroids
• Fungal abscesses must be drained
• Treatment of the underlying condition causing a poor immune system
• Intravenous antifungal treatment, usually with voriconazole
• Adequate self-care can help shorten the recovery period. Thus, certain basic steps to be followed include:
  • Regular washing and cleaning of the skin surface to prevent spread of the infection to other regions
  • Using clean and disinfected towels, combs, and hairbrushes
  • Disinfecting common shared spaces, like toilets and shower areas, bathtubs, kitchens, bedrooms
  • Applying the prescribed creams and taking the prescribed oral medications regularly
• If bacterial infections complicate the condition, then antibacterial antibiotics are prescribed
• In order to avoid recurrence of the infection, the antifungal treatment measures have to be continued for an extended period of time (per advice of the physician); even after the condition has been controlled
• Improved nutrition and overall health status

How can Scedosporium Infection of Skin be Prevented?

It may not be possible to completely avoid the Scedosporium fungus, due to their worldwide distribution. Nevertheless, some safety and precautionary measures may help in preventing Scedosporium Infection of Skin. These include:

• Avoid exposure to the Scedosporium fungus: Individuals (especially those with a weakened immune system) should avoid areas where the fungus grows and thrives such as soils and contaminated water bodies
• Minimize or avoid activities that involve the soil and dust (especially individuals who are immunocompromised)
• Avoid handling fecal matter of farm animals, such as cattle, and birds
• Wash and clean skin injuries with soap and water
• Avoid consuming contaminated food and water
• Educate and create an awareness about the adverse health effects of Scedosporium

Good hygiene and a healthy lifestyle improves the body immune system against infections such as caused by Scedosporium.

What is the Prognosis of Scedosporium Infection of Skin? (Outcomes/Resolutions)

• The prognosis of localized form of Scedosporium Infection of Skin in healthy individuals with appropriate treatment is excellent
• Skin-related fungal infections usually respond well to treatment, with over-the-counter antifungal medications and dry powder applications
• A lack of proper treatment, poor health status of the individual, and the presence of severe complications are all factors that may affect the prognosis adversely
• If the Scedosporium infection of Skin has spread to internal organs, the prognosis is worse

Additional and Relevant Useful Information for Scedosporium Infection of Skin:

Scedosporium can cause infection anywhere in the body. The infection can be localized (confined to a part or region) or disseminated (widespread disease affecting many body organs).

Scedosporium is placed scientifically in the larger group termed Fungus (plural Fungi). The smaller, more precise term for Scedosporium is mold. Other common molds are Fusarium, Alternaria, and Aspergillus. Also, among the fungus category are yeasts, which usually grow as single cells. A common disease causing yeast is Candida.