1 INTRODUCTION
The Scedosporium is a group of soil saprophytic moulds, which are widely distributed in the environment, particularly in soil, sewage and polluted waters. At least ten distinct Scedosporium species have been identified in molecular taxonomy. Five of them can cause human infections, namely S apiospermum, P boydii, Saurantiacum, S dehoogii and S minutispora 1-3. And their environmental distribution and epidemiology is different worldwide4-8. As opportunistic pathogens, infections caused by Scedosporium genus will happen in not only immunosuppressed but immunocompetent hosts, but most infections are associated with compromised immune status9. The clinical manifestation of infections include respiratory colonization, cutaneous infections, and severe invasive localized or disseminated mycosis. There is even a risk of central nervous system infection after drowning in immunocompetent hosts1, and the mortality rate of susceptible people exceeds 50%2. Immunosuppression may increase the prevalence of disseminated infections caused by Scedosporium , such as in patients with cancer, hematopoietic stem cells or solid organ transplant recipients, and those receiving immunosuppressive therapy7. To immunocompetent populations, Scedosporium infections frequently caused by trauma, drowning, and aspiration of conidia1,9, mainly infecting the skin, lungs, soft tissues, central nervous system, and sinuses, among which pulmonary infections rank the second10-11, and those with underlying lung diseases are more susceptible than other healthy people12. Treatment of Scedosporium infections still remains a great challenge because of their intrinsic resistance to all current antifungal agents, easy to relapse, and the mixed infection with tuberculosis or non-tuberculous mycobacteria or viruses occur frequently14-16. Voriconazole has been recommended to the first-line systemic treatment of Scedosporiuminfections13, but the duration of therapy is not well recommended. Therefore, it is necessary to summarize the clinical cases and treatment experience of Scedosporium infections, especially the risk factors, infection routes, therapeutic strategies and duration of treatment in immunocompetent patients. In this paper, we retrospectively analyzed 3 cases of non-Transplant, non-HIV adults withScedosporium pneumonia, and present our therapeutic experience and improved patient outcomes.