What is it about?
People who have received an organ transplant take drugs that weaken the immune system, which makes them prone to unusual infections and to skin cancers. We describe a 75-year-old woman with a kidney transplant who developed firm, growing lumps on her lower leg over two months. They looked like a skin tumour, but a small biopsy showed fungal filaments and the culture grew Scedosporium, a mould that is rarely seen in the skin and resistant to many antifungal drugs. A CT scan showed that the infection had not spread. Treatment with the antifungal voriconazole, combined with surgical removal of the infected tissue, vacuum-assisted wound therapy and a skin graft, led to complete healing within three months, with no relapse after one year.
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Photo by Timothy Dykes on Unsplash
Why is it important?
Cutaneous Scedosporium infection is extremely rare and easily mistaken for squamous cell carcinoma, which is itself common in transplant recipients. This case shows why any new or atypical skin nodule in a transplanted patient should be biopsied and cultured early, and how a coordinated team of plastic surgeons, infectious diseases specialists and transplant physicians can achieve a full cure of an infection that is often difficult to treat.
Perspectives
This case is a reminder that in immunocompromised patients 'it looks like cancer' is not a diagnosis. A simple biopsy, sent for both histology and culture, changed everything. I am grateful to our plastic surgery colleagues in Trieste for an excellent multidisciplinary collaboration.
Professor Stefano Di Bella
Universita degli Studi di Trieste
Read the Original
This page is a summary of: Cutaneous Scedosporium infection mimicking malignancy in a kidney transplant recipient: A case report, Diagnostic Microbiology and Infectious Disease, June 2026, Elsevier,
DOI: 10.1016/j.diagmicrobio.2026.117347.
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