Hematogenous Dissemination of Scedosporiosis in an Immunocompetent Patient

Abstract Scedosporiosis is becoming an increasingly recognized cause of treatment-resistant opportunistic infections in immunocompromised patients. Fungal infections with Scedosporium spp. have also been seen in immunocompetent patients with previously damaged bronchopulmonary trees. Presentation may be associated with mycetoma, sinopulmonary involvement, extrapulmonary localized infections, and, in rare cases, disseminated infections. We present a case of an immunocompetent 57-year-old woman with prior pulmonary tuberculosis who was found to have Scedosporium boydii/apiospermum pneumonia and Scedosporium osteomyelitis. Multiple bone cultures were negative prior to diagnostic confirmation by 28S ribonucleic acid polymerase chain reaction sequencing. This case illustrates the rare occurrence of hematogenous spread in an immunocompetent patient and the diagnostic and therapeutic challenges associated with Scedosporium spp. infections.