Mould Identification: A Virtual Self Assessment
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Please find additional information below
Unknown 3 = Lomentospora prolificans
|A 73 year old man on chemotherapy for AML - Fludarabine, Cytarabine with gCSF. Profound pancytopenia from day 5 post chemotherapy. Developed rigor and fever on day 14 with no foacl symptoms or signs. Empiric antibacterials commenced - cefepime and gentamicin. Ongoing sepsis therefore antibiotics replaced after 4 days with meropenem and teicoplanin. Liposomal Amphotericin added after 7 days. Erythematous rash was also noted at this time and blood cultures grew the fungus below.|
|One of the erythematous skin papules on the thighs.
In the Australian Scedosporium Study, to date 5 cases of L. prolificans have been reported from blood cultures and have all been associated with a rash - this may be a useful clinical marker.
Culture of L. prolificans on Sabouraud's dextrose agar are rapid growing, flat, spreading, olive-grey to black and often have an initial yeast like appearance but soon become suede-like to downy with age.
Microscopic morphology of Lomentospora prolificans. Conidia are borne in small groups on distinctive basally swollen, flask-shaped annellides, which occur singly or in clusters along the vegetative hyphae. Conidia are single-celled, hyaline to pale-brown, ovoid to pyriform and have smooth thin walls. Lomentospora prolificans is distinguished from Scedosporium apiospermum, by having basally swollen (inflated), flask-shaped annellides, slower colony development on nutrient agar media, and by not growing on media containing cycloheximide (actidione).
What is your identification?