Immunosuppressive therapy following kidney transplantation increases susceptibility to opportunistic infections, including rare fungal pathogens. Scedosporium apiospermum (ScAP) is an emerging opportunistic fungal pathogen known for causing invasive infections, particularly in immunocompromised patients. Here, we present a 44-year-old female with two prior live-related kidney transplants who developed cerebrospinal fluid rhinorrhea in November 2024. Magnetic resonance imaging revealed a cribriform plate defect and a fungal infection of the maxillary sinus, and surgical drainage identified ScAP via MALDI-TOF mass spectrometry. This case highlights a rare fungal infection in a transplant recipient. With fungal KOH, septate fungal hyphae were seen, and the culture showed fungal growth; however, it did not ascertain the exact organism, nor resemble that of Aspergillus . Hence, the culture was sent for MALDI-TOF-MS which helped in the identification of ScAP. MALDI-TOF-MS helps in early diagnosis and facilitates timely intervention, which can improving patient outcomes.
Narayana et al. (Thu,) studied this question.