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Journal of Clinical Microbiology, February 2005, p. 973-977, Vol. 43, No. 2
0095-1137/05/$08.00+0     doi:10.1128/JCM.43.2.973-977.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.

CASE REPORT

Scedosporium apiospermum Soft Tissue Infection Successfully Treated with Voriconazole: Potential Pitfalls in the Transition from Intravenous to Oral Therapy

Joanna M. Schaenman,1* Daniel B. DiGiulio,1,2 Laurence F. Mirels,2,3 Nancy M. McClenny,4 Gerald J. Berry,5 Annette W. Fothergill,6 Michael G. Rinaldi,6 and Jose G. Montoya1,2,7

Department of Medicine,1 Division of Infectious Diseases and Geographic Medicine,2 Clinical Microbiology Laboratory,4 Department of Pathology, Stanford University School of Medicine, Stanford,5 Department of Medicine, Division of Infectious Diseases, Santa Clara Valley Medical Center and California Institute for Medical Research, San Jose,3 Department of Immunology and Infectious Diseases, Palo Alto Medical Foundation Research Institute, Palo Alto, California,7 Department of Pathology, University of Texas Health Science Center at San Antonio, San Antonio, Texas6

Received 26 April 2004/ Returned for modification 18 June 2004/ Accepted 17 September 2004

An immunocompromised patient with an invasive soft tissue infection due to Scedosporium apiospermum was successfully treated with voriconazole and surgical debridement. After transition from intravenous to oral therapy, successive adjustments of the oral dose were required to achieve complete resolution. For soft tissue infections due to molds characterized by thin, septate hyphae branching at acute angles, voriconazole should be considered a first-line antifungal agent. The potential usefulness of plasma voriconazole levels for guiding optimal therapy should be investigated.

* Corresponding author. Mailing address: Department of Medicine, Stanford University School of Medicine, 300 Pasteur Dr., Rm. S-100, Stanford, CA 94305. Phone: (650) 723-6661. Fax: (650) 498-6205. E-mail: joannas{at}stanford.edu.

Journal of Clinical Microbiology, February 2005, p. 973-977, Vol. 43, No. 2
0095-1137/05/$08.00+0     doi:10.1128/JCM.43.2.973-977.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.



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