# Deciphering Unexpected Vascular Locations of Scedosporium spp. and Lomentospora prolificans Fungal Infections, France

## TL;DR

This study explores how certain fungi, Scedosporium spp. and Lomentospora prolificans, commonly infect blood vessels and bones, especially in immunosuppressed individuals.

## Contribution

The study identifies a high frequency of vascular infections and aneurysms in patients with Scedosporium spp. and Lomentospora prolificans, emphasizing the need for vascular imaging.

## Key findings

- 70% of patients with Scedosporium spp. and L. prolificans infections had underlying immunosuppression, often due to solid organ transplants.
- Osteoarticular infections were common and often contiguous with vascular infection sites.
- Vascular imaging like computed tomography angiography is recommended for managing these infections.

## Abstract

Scedosporium spp. and Lomentospora prolificans are emerging non-Aspergillus filamentous fungi. The Scedosporiosis/lomentosporiosis Observational Study we previously conducted reported frequent fungal vascular involvement, including aortitis and peripheral arteritis. For this article, we reviewed 7 cases of Scedosporium spp. and L. prolificans arteritis from the Scedosporiosis/lomentosporiosis Observational Study and 13 cases from published literature. Underlying immunosuppression was reported in 70% (14/20) of case-patients, mainly those who had solid organ transplants (10/14). Osteoarticular localization of infection was observed in 50% (10/20) of cases; infections were frequently (7/10) contiguous with vascular infection sites. Scedosporium spp./Lomentospora prolificans infections were diagnosed in 9 of 20 patients ≈3 months after completing treatment for nonvascular scedosporiosis/lomentosporiosis. Aneurysms were found in 8/11 aortitis and 6/10 peripheral arteritis cases. Invasive fungal disease­–related deaths were high (12/18 [67%]). The vascular tropism of Scedosporium spp. and L. prolificans indicates vascular imaging, such as computed tomography angiography, is needed to manage infections, especially for osteoarticular locations.