Pseudallescheriasis: A summary of patients from 1980-2003 in a tertiary care center

Context.-Pseudallescheria boydii is being increasingly isolated in immunocompromised patients. Objective.-To present 24 years of data on patients from whom P boydii was isolated. Design.-Retrospective review of archival laboratory data and patient charts at a tertiary care hospital with a full service mycology laboratory. All patients evaluated from whom P boydii was isolated between 1980 and 2003 were included in this study. Results.-Twenty-four patients from whom P boydii had been isolated were identified. The majority of cases represented pulmonary involvement, particularly in cystic fibrosis patients. Three additional patients had infections in surgical or traumatic lesions of the head and 4 had disseminated disease. Invasive disease was associated with underlying malignancy or transplantation and resulted in death secondary to the fungal infection in the majority of cases. Conclusions.- Pseudallescheria boydii may cause significant disease in humans. Invasive infections with P boydii are often misdiagnosed and inadequately treated. Aggressive treatment of locally invasive disease may be of value in preventing rapid and fatal dissemination with this organism.