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Review

Recurrent Scedosporium apiospermum Cutaneous Infection in a Patient with Rheumatoid Arthritis: The Potent Role of IL-6 Signaling Pathway Blockade: A Case-Based Review

by
Antigone Pieta
1,
Aliki I. Venetsanopoulou
1,
Christos Kittas
2,
Eirini Christaki
3,* and
Paraskevi V. Voulgari
1
1
Department of Rheumatology, School of Health Sciences, Faculty of Medicine, University of Ioannina, 45110 Ioannina, Greece
2
Microbiology Laboratory, School of Health Sciences, Faculty of Medicine, University of Ioannina, 45110 Ioannina, Greece
3
1st Division of Internal Medicine & Infectious Diseases Unit, University General Hospital of Ioannina, Faculty of Medicine, University of Ioannina, 45110 Ioannina, Greece
*
Author to whom correspondence should be addressed.
J. Fungi 2023, 9(6), 683; https://doi.org/10.3390/jof9060683
Submission received: 13 March 2023 / Revised: 8 June 2023 / Accepted: 13 June 2023 / Published: 18 June 2023
(This article belongs to the Special Issue Diagnostic and Therapeutic Challenges of Human Fungal Infections)
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Abstract

Rheumatoid arthritis (RA) patients deal with a higher risk of bacterial and fungal infections compared to the general population because of their dysregulated immune system as well as the immunosuppressive therapy they usually receive. Scedosporium spp. is a fungal pathogen responsible for cutaneous, lung, central nervous system, and eye infections, mostly in immunocompromised patients, leading to death in disseminated cases. We report the case of an 81-year-old woman with rheumatoid arthritis treated with steroids and an IL-6 inhibitor who was diagnosed with scedosporiosis of the upper limb. She was treated with voriconazole for one month, which was discontinued due to adverse events, and when scedosporiosis relapsed, she switched to itraconazole. We also reviewed the current literature on RA patients presenting with Scedosporium infections. Early and accurate diagnosis of scedosporiosis has therapeutic and prognostic implications, as traditionally this fungus is resistant to commonly used antifungals. Clinical alertness regarding uncommon infections, including fungal, in patients with autoimmune diseases on immunomodulatory agents is essential for effective treatment.
Keywords: fungal infection; Scedosporium apiospermum; rheumatoid arthritis; IL-6 inhibitor; immunosuppression fungal infection; Scedosporium apiospermum; rheumatoid arthritis; IL-6 inhibitor; immunosuppression

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MDPI and ACS Style

Pieta, A.; Venetsanopoulou, A.I.; Kittas, C.; Christaki, E.; Voulgari, P.V. Recurrent Scedosporium apiospermum Cutaneous Infection in a Patient with Rheumatoid Arthritis: The Potent Role of IL-6 Signaling Pathway Blockade: A Case-Based Review. J. Fungi 2023, 9, 683. https://doi.org/10.3390/jof9060683

AMA Style

Pieta A, Venetsanopoulou AI, Kittas C, Christaki E, Voulgari PV. Recurrent Scedosporium apiospermum Cutaneous Infection in a Patient with Rheumatoid Arthritis: The Potent Role of IL-6 Signaling Pathway Blockade: A Case-Based Review. Journal of Fungi. 2023; 9(6):683. https://doi.org/10.3390/jof9060683

Chicago/Turabian Style

Pieta, Antigone, Aliki I. Venetsanopoulou, Christos Kittas, Eirini Christaki, and Paraskevi V. Voulgari. 2023. "Recurrent Scedosporium apiospermum Cutaneous Infection in a Patient with Rheumatoid Arthritis: The Potent Role of IL-6 Signaling Pathway Blockade: A Case-Based Review" Journal of Fungi 9, no. 6: 683. https://doi.org/10.3390/jof9060683

APA Style

Pieta, A., Venetsanopoulou, A. I., Kittas, C., Christaki, E., & Voulgari, P. V. (2023). Recurrent Scedosporium apiospermum Cutaneous Infection in a Patient with Rheumatoid Arthritis: The Potent Role of IL-6 Signaling Pathway Blockade: A Case-Based Review. Journal of Fungi, 9(6), 683. https://doi.org/10.3390/jof9060683

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