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

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

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=9

YEAR=2022

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2022.1045353

DOI=10.3389/fcvm.2022.1045353

ISSN=2297-055X

ABSTRACT=<p><italic>Scedosporium apiospermum</italic> associated endocarditis is extremely rare. We report a case of a disseminated <italic>S. apiospermum</italic> 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 [<sup>18</sup>F]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 <italic>S. apiospermum</italic>. 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.</p>