{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T22:57:34Z","timestamp":1793833054840,"version":"4.6.1"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T00:00:00Z","timestamp":1771545600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2,28]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Lomentospora prolificans and Scedosporium spp. are emerging non-Aspergillus moulds causing invasive fungal disease (IFD) in onco-haematology patients. Rhino-sino-orbital and\/or central nervous system (CNS) infections are poorly described yet associated with high mortality. We aimed to characterize clinical, microbiological, treatment, and outcome features of rhino-sino-orbital and\/or CNS infections due to these moulds in an onco-haematology population. We retrospectively reviewed proven\/probable IFD patients with rhino-sino-orbital and\/or CNS involvement from 2010 to 2024 caused by L. prolificans and Scedosporium spp. at two Australian tertiary centres in adults with cancer. Eighteen episodes were analysed; 94.5% had haematological malignancy, mainly acute myeloid leukaemia (41.5%), and 53% were haematopoietic stem cell transplant recipients. Lomentospora prolificans predominated (83%) and displayed intrinsic resistance to conventional antifungals. Olorofim showed potent in vitro activity when tested (n\u00a0=\u00a05, MIC 0.125\u20130.5\u00a0mg\/l). Disseminated disease occurred in 78%, mainly affecting lung (79%), CNS (64%), and eye (43%). Initial combination therapy with a voriconazole and terbinafine-including regimen was used in 87.5% and surgery in 50%; olorofim was administered to five patients. Overall mortality was high: 56% at 30-day and 67% at 180-day follow-up, with early death noted if there was CNS involvement (70%). Lower 30-day and 180-day mortality was observed in localized rhino-sino-orbital and Scedosporium spp. infections (0% and 20%, respectively), particularly when surgery and olorofim were used. Our results underline the high mortality from L. prolificans infections in onco-haematology patients with disseminated disease or CNS involvement. Early aggressive surgery and novel antifungals may improve outcomes, but prospective multicentre studies are needed to define optimal treatment strategies.<\/jats:p>","DOI":"10.1093\/mmy\/myag016","type":"journal-article","created":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T12:57:08Z","timestamp":1771505828000},"source":"Crossref","is-referenced-by-count":2,"title":["Rhino-sino-orbital and\/or central nervous system infections due to\n                    <i>Lomentospora prolificans<\/i>\n                    and\n                    <i>Scedosporium<\/i>\n                    spp. in onco-haematology patients"],"prefix":"10.1093","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6217-6501","authenticated-orcid":false,"given":"Enric","family":"Sastre-Escol\u00e0","sequence":"first","affiliation":[{"name":"Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), University of Barcelona, L\u2019Hospitalet de Llobregat Infectious Diseases Department, , Barcelona ,","place":["Spain"]},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III , Madrid ,","place":["Spain"]},{"name":"Institut Catal\u00e0 d\u2019Oncologia (ICO), Hospital Duran i Reynals, L\u2019Hospitalet de Llobregat , Barcelona ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle K","family":"Yong","sequence":"additional","affiliation":[{"name":"National Centre for Infections in Cancer, Peter MacCallum Cancer Centre , Melbourne, Victoria ,","place":["Australia"]},{"name":"Peter MacCallum Cancer Centre Department of Infectious Diseases, , Melbourne, Victoria ,","place":["Australia"]},{"name":"Victorian Infectious Diseases Service, The Royal Melbourne Hospital , Melbourne, Victoria ,","place":["Australia"]},{"name":"The University of Melbourne Sir Peter MacCallum Department of Oncology, , Melbourne, Victoria ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shio Yen","family":"Tio","sequence":"additional","affiliation":[{"name":"National Centre for Infections in Cancer, Peter MacCallum Cancer Centre , Melbourne, Victoria ,","place":["Australia"]},{"name":"Peter MacCallum Cancer Centre Department of Infectious Diseases, , Melbourne, Victoria ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abby","family":"Douglas","sequence":"additional","affiliation":[{"name":"National Centre for Infections in Cancer, Peter MacCallum Cancer Centre , Melbourne, Victoria ,","place":["Australia"]},{"name":"Victorian Infectious Diseases Service, The Royal Melbourne Hospital , Melbourne, Victoria ,","place":["Australia"]},{"name":"The University of Melbourne Sir Peter MacCallum Department of Oncology, , Melbourne, Victoria ,","place":["Australia"]},{"name":"Austin Health Department of Infectious Diseases, , Melbourne, Victoria ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C Orla","family":"Morrissey","sequence":"additional","affiliation":[{"name":"Alfred Health Department of Infectious Diseases, , Melbourne, Victoria ,","place":["Australia"]},{"name":"School of Translational Medicine, Monash University Department of Infectious Diseases, , Melbourne, Victoria ,","place":["Australia"]},{"name":"Centre to Impact AMR, Monash University, Clayton Campus , Clayton, Victoria ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gemma","family":"Reynolds","sequence":"additional","affiliation":[{"name":"National Centre for Infections in Cancer, Peter MacCallum Cancer Centre , Melbourne, Victoria ,","place":["Australia"]},{"name":"Peter MacCallum Cancer Centre Department of Infectious Diseases, , Melbourne, Victoria ,","place":["Australia"]},{"name":"Austin Health Department of Infectious Diseases, , Melbourne, Victoria ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4250-4448","authenticated-orcid":false,"given":"Lynette","family":"Chee","sequence":"additional","affiliation":[{"name":"Peter MacCallum Cancer Centre and the Royal Melbourne Hospital Department of Clinical Haematology, , Melbourne, Victoria ,","place":["Australia"]},{"name":"University of Melbourne Department of Medicine, , Victoria ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashish","family":"Bajel","sequence":"additional","affiliation":[{"name":"Peter MacCallum Cancer Centre and the Royal Melbourne Hospital Department of Clinical Haematology, , Melbourne, Victoria ,","place":["Australia"]},{"name":"University of Melbourne Department of Medicine, , Victoria ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John H","family":"Rex","sequence":"additional","affiliation":[{"name":"F2G Ltd., Nether Alderley , Macclesfield ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8443-314X","authenticated-orcid":false,"given":"Monica","family":"Slavin","sequence":"additional","affiliation":[{"name":"National Centre for Infections in Cancer, Peter MacCallum Cancer Centre , Melbourne, Victoria ,","place":["Australia"]},{"name":"Peter MacCallum Cancer Centre Department of Infectious Diseases, , Melbourne, Victoria ,","place":["Australia"]},{"name":"Victorian Infectious Diseases Service, The Royal Melbourne Hospital , Melbourne, Victoria ,","place":["Australia"]},{"name":"The University of Melbourne Sir Peter MacCallum Department of Oncology, , Melbourne, Victoria ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2462-2958","authenticated-orcid":false,"given":"Chin Fen","family":"Neoh","sequence":"additional","affiliation":[{"name":"National Centre for Infections in Cancer, Peter MacCallum Cancer Centre , Melbourne, Victoria ,","place":["Australia"]},{"name":"Peter MacCallum Cancer Centre Department of Infectious Diseases, , Melbourne, Victoria ,","place":["Australia"]},{"name":"Victorian Infectious Diseases Service, The Royal Melbourne Hospital , Melbourne, Victoria ,","place":["Australia"]},{"name":"The University of Melbourne Sir Peter MacCallum Department of Oncology, , Melbourne, Victoria ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,2,20]]},"reference":[{"issue":"1","key":"2026031804115601800_bib1","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1016\/j.cmi.2024.08.006","article-title":"Invasive fungal disease in the immunocompromised host: changing epidemiology, new antifungal therapies, and management 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