Would you treat Scedosporium growth in expectorated sputum in a patient with COPD, pulmonary hypertension, and bronchiectasis, who has chronic dyspnea with exertion, thick sputum production, negative bacterial cultures, and no signs of mold infection on a high resolution CT scan, with no other clinical symptoms of infection?

Answer from: at Academic Institution

In persons with bronchiectasis, almost anything that grows can be a pathogen, but it is tough to know. If the patient has COPD and no other immunocompromising conditions, I would not expect typical invasive fungal infection findings. Having said that, scedosporium is not the first common pathogen th...

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at Hurley Medical Center
The patient was on MTX for RA in the past, when sp...

Answer from: at Community Practice

No, I would not. The patient described seems to be colonized with Scedosporium. There is no evidence of invasive disease, so I have no reason to think that antifungal treatment would provide them any benefit.

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at Hurley Medical Center
The challenge is determining colonization vs infec...

at National Institute of Allergy and Infectious Diseases (NIAID)
I am definitely not an expert on bronchiectasis an...

Answer from: at Community Practice

I would agree with Dr. @Denis Hadjiliadis's answer. While most of the time Scedo growth likely represents colonization in patients with bronchiectasis, it can sometimes (rarely?) represent true disease. I would be in favor of treatment if (1) it grows repeatedly (at least 3 times in my opinion), (2)...

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at National Institute of Allergy and Infectious Diseases (NIAID)
First, the case you are describing and the case pr...

at Hurley Medical Center
So far, I have not treated the patient for the sce...

at University of California, Davis Health
I agree with not treating, Danielle. Thank you for...

at Hospital of the University of Pennsylvania
Thank you for the update Danielle. From what you ...

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