[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Microbiology](https://durgical.com/en/microbiology/) › [Molds and dermatophytes](https://durgical.com/en/microbiology/groups/molds-and-dermatophytes/) › Fusarium and Scedosporium

# Fusarium and Scedosporium

- Fungus
- Exam priority: medium

Clear (non-pigmented) environmental molds that cause eye infections after trauma or contact lenses and deadly infections in neutropenic patients.

Updated Nov 13, 2026

Also called: fusariosis, Scedosporium apiospermum, Lomentospora prolificans, hyalohyphomycosis

## Quick facts

**Type**
Fungus · [Molds and dermatophytes](https://durgical.com/en/microbiology/groups/molds-and-dermatophytes/)

**Gram / shape**
Thin septate hyphae with acute-angle branching

**Spread**
Corneal trauma with plant material

**Causes**
Fungal keratitis · Disseminated fusariosis

**Treatment**
Fusarium

On this page

- The basics Key points
- At a glance
- Morphology
- Transmission
- In Colombia
- Memory aid
- What the colours mean

- Clinical Virulence factors
- Diseases it causes
- Clinical picture
- Diagnosis

- Treatment Treatment
- Prevention

- Study Test yourself

- Connections Connections

## Key points

- Fusarium: keratitis in healthy eyes; disseminated infection with painful necrotic skin nodules in neutropenia.
- Unlike Aspergillus, Fusarium often grows in blood cultures (adventitious sporulation).
- Banana-shaped macroconidia in culture = Fusarium.
- Scedosporium: near-drowning in polluted water, then pneumonia and brain abscess.
- Intrinsic resistance: Fusarium ignores echinocandins; Lomentospora prolificans resists almost everything.

## At a glance

**Shape**
Thin septate hyphae with acute-angle branching in tissue, like Aspergillus; Fusarium makes banana-shaped macroconidia in culture

**Family**
Fusarium: Nectriaceae; Scedosporium and Lomentospora: Microascaceae

**Type**
Hyaline (non-pigmented) filamentous molds

**Stain**
KOH, calcofluor white, GMS or PAS; culture needed to tell them from Aspergillus

## Morphology

- Fusarium: in culture, cottony colonies, often pink to violet, with curved multicellular (banana-shaped) macroconidia.
- Scedosporium apiospermum: gray-white colonies with oval single-celled conidia.
- In tissue all look like Aspergillus: hyaline septate hyphae that invade blood vessels.

## Transmission

- Corneal trauma with plant material, or contamination of contact lenses and lens cases (keratitis).
- Inhalation of conidia from air, soil or hospital water (sinuses and lungs).
- Entry through damaged skin or nails (onychomycosis is a common door for disseminated fusariosis); aspiration of polluted water in near-drowning (Scedosporium).

**Reservoir:** Soil, plants and water, including hospital water systems and shower heads (Fusarium); Soil, sewage and polluted water (Scedosporium)

### Isolation precautions

What the care team adds to standard precautions.

- Standard

## Virulence factors

- Angioinvasion with thrombosis and tissue necrosis, as in aspergillosis.
- Fusarium sporulates inside tissue (adventitious sporulation), so blood cultures are often positive.
- High intrinsic resistance to many antifungals: Fusarium resists echinocandins and fluconazole; Lomentospora prolificans resists almost all drugs.

## Diseases it causes

- Fungal keratitis: Fusarium is a leading cause after plant trauma or contact lens use. [Keratitis and corneal ulcer →](https://durgical.com/en/conditions/keratitis-and-corneal-ulcer/)
- Disseminated fusariosis in prolonged neutropenia or after stem cell transplant: fever, painful necrotic skin nodules, lung lesions, positive blood cultures. [Febrile neutropenia →](https://durgical.com/en/conditions/febrile-neutropenia/)
- Scedosporium: eumycetoma after trauma, pneumonia and brain abscess after near-drowning, and airway colonization in cystic fibrosis. [Mycetoma (actinomycetoma and eumycetoma) →](https://durgical.com/en/conditions/mycetoma/)

## Clinical picture

- Keratitis: pain, red eye and a feathery-edged corneal infiltrate, sometimes with hypopyon.
- Neutropenic fusariosis: many painful red papules or nodules with central necrosis on the limbs, often starting from an infected toenail.
- Scedosporium is one of the molds most often isolated from respiratory secretions in cystic fibrosis.

## Diagnosis

- Corneal scrapings: KOH or calcofluor and culture.
- Deep skin biopsy with histology and culture in disseminated disease; blood cultures are often positive in fusariosis, unlike aspergillosis.
- Galactomannan may be positive; beta-D-glucan helps more to rule out than to confirm.
- Species identification by molecular methods or mass spectrometry is important because susceptibility differs.

## Treatment

Fusarium: voriconazole or lipid amphotericin B, sometimes combined, plus surgical debridement; topical antifungals (natamycin, voriconazole) for keratitis. Scedosporium apiospermum: voriconazole first. Lomentospora prolificans is resistant to most antifungals. Recovery of neutrophils largely decides survival.

Drug class only; doses and regimens are set by the clinician from the current guideline.

In Pharmacology:

- [Voriconazole](https://durgical.com/en/pharmacology/voriconazole/)
- [Amphotericin B](https://durgical.com/en/pharmacology/amphotericin-b/)
- [Posaconazole](https://durgical.com/en/pharmacology/posaconazole/)

## Prevention

- Correct contact lens hygiene: never tap water, change the case, do not sleep or swim with lenses.
- Looking for and treating onychomycosis and skin breaks before chemotherapy.
- Mold-active prophylaxis and water and air control in hematology units.

## In Colombia

Fusarium is among the common agents of fungal keratitis in tropical countries. In Brazilian series, fusariosis is the second most frequent invasive mold in hematology patients.

## Memory aid

«Bananas in the blood»: Fusarium makes banana-shaped spores and, unlike Aspergillus, shows up in the blood culture; Scedosporium «swims» into the lungs after a near-drowning.

## Test yourself

Think of the answer, then tap the question to see it.

## Which mold is a leading cause of fungal keratitis after plant trauma or contact lens use?

Fusarium.

## Why are blood cultures often positive in fusariosis but not in aspergillosis?

Fusarium produces spores inside tissue (adventitious sporulation) that are released into the blood.

## What skin finding suggests disseminated fusariosis in a neutropenic patient?

Multiple painful red papules or nodules with central necrosis, often with a toenail infection as the entry point.

## Which setting is classic for Scedosporium apiospermum infection in a healthy person?

Near-drowning in polluted water, followed by pneumonia and brain abscess.

[Add to my cards (4)](https://durgical.app/estudiar/?add=/en/microbiology/fusarium-and-scedosporium/)

## What the colours mean

**Gram-positive**
Thick peptidoglycan wall: stains purple.

**Gram-negative**
Thin wall with an outer membrane: stains pink.

**Acid-fast**
Lipid-rich wall (mycobacteria): Ziehl–Neelsen stain.

## Connections

## Related 5

- [Aspergillus fumigatus](https://durgical.com/en/microbiology/aspergillus-fumigatus/)
- [Mucorales (Rhizopus, Mucor)](https://durgical.com/en/microbiology/mucorales/)
- [Agents of phaeohyphomycosis (Exophiala, Alternaria, Cladophialophora and other dematiaceous molds)](https://durgical.com/en/microbiology/agents-of-phaeohyphomycosis/)
- [Mycetoma agents](https://durgical.com/en/microbiology/mycetoma-agents/)
- [Acanthamoeba spp.](https://durgical.com/en/microbiology/acanthamoeba-spp/)

## Related conditions 3

- [Keratitis and corneal ulcer](https://durgical.com/en/conditions/keratitis-and-corneal-ulcer/)
- [Febrile neutropenia](https://durgical.com/en/conditions/febrile-neutropenia/)
- [Mycetoma (actinomycetoma and eumycetoma)](https://durgical.com/en/conditions/mycetoma/)

[← Back to the group: Molds and dermatophytes](https://durgical.com/en/microbiology/groups/molds-and-dermatophytes/)

Educational content on microorganisms; not a treatment guide and no substitute for a health professional's advice. No doses are given.

Sources: [Invasive fusariosis](https://pmc.ncbi.nlm.nih.gov/articles/PMC10732078/) (Clinical Microbiology Reviews (PMC), 2023); [Infections Caused by Scedosporium spp.](https://pmc.ncbi.nlm.nih.gov/articles/PMC2223844/) (Clinical Microbiology Reviews (PMC), 2008); [Rare fungal infectious agents: a lurking enemy](https://pmc.ncbi.nlm.nih.gov/articles/PMC5664977/) (F1000Research (PMC), 2017).

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Representative model, for educational purposes only.

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License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/microbiology/fusarium-and-scedosporium/