Bilateral multilobar cavitary pneumonia in an immunocompetent host. A case report of invasive pulmonary Scedosporium spp infection

Background: Scedosporium spp is an established cause of multisystemic clinical disease in immunocompromised patients. Invasive lung disease has been reported in immunocompetent hosts, the majority of whom have pre-existent structural lung disease. Case Presentation: We present a case of a 31-year-old African American man who presented with cough and hemoptysis for four months. Lung imaging revealed bilateral multilobar cavitary infiltrates. Bronchial alveolar lavage fungal cultures resulted in positive for Scedosporium spp . Work up for alternative causes of cavitary pneumonias, including Mycobacterium tuberculosis , as well as immunodeficiency syndromes, was negative. He achieved complete symptom resolution with radiological improvement on voriconazole therapy. Conclusion: Scedosporium spp is emerging as a possible rare cause of cavitary pneumonias in immunocompetent patients without pre-existing lung disease. An accurate diagnosis is important as treatment involves a long course of antifungal therapy.