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The case describes a 44-year-old Chinese male who developed disseminated infection and fatal endocarditis after exposure to a nearly dry wastewater pool. Blood isolates were identified using nanopore sequencing (ITS1) and MALDI-TOF MS; susceptibility testing showed voriconazole activity (MIC 0.5 μg/mL). Despite appropriate antifungal therapy, uncontrolled infection led to systemic organ failure, highlighting the need for early exposure history, rapid molecular identification, and drug susceptibility testing.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":40,"@type":76,"position":81},"https://docshare.wps.com/document/research-report/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/first-report-of-scedosporium-aurantiacum-endocarditis-in-an-immunocompetent-chinese-male-and-literature-review/420364/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/first-report-of-scedosporium-aurantiacum-endocarditis-in-an-immunocompetent-chinese-male-and-literature-review/420364.png","ImageObject",300,407,{"name":92,"@type":93},"OmBimo","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-09-30","2026-09-28",true,{"@type":102,"interactionType":103,"userInteractionCount":14},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What exposure likely led to the patient’s infection?","Question",{"text":112,"@type":113},"The patient developed disease after falling into a nearly dry wastewater pool, suggesting exposure to contaminated environments.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How was Scedosporium aurantiacum identified in this case?",{"text":117,"@type":113},"The isolate from blood cultures was identified using nanopore sequencing of ITS1 and MALDI-TOF mass spectrometry.",{"name":119,"@type":110,"acceptedAnswer":120},"Which antifungal showed the strongest in vitro activity and what was the outcome?",{"text":121,"@type":113},"Voriconazole was the most active agent in vitro (MIC 0.5 μg/mL). Despite appropriate therapy, the patient died 12 days after fungal isolation due to uncontrolled infection and systemic organ failure.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},420364,1790741795,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":39,"category_name":40,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":14,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":52,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144},962090893581,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","Infection and Drug Resistance  \n Open Access Full Text Article  \nC ASE REPORT  \nFirst Report of Scedosporium aurantiacum Endocarditis in an Immunocompetent Chinese Male and Literature Review  \nChen Liu , Xiaohua Qin, Pei Zhang, Liping Wang, Yunfeng Deng  \nDepartment of Katharine Hsu International Research Center of Human Infectious Diseases, Public Health Clinical Center Affiliated to Shandong University, Jinan, People’s Republic of China  \nCorrespondence: Liping Wang; Yunfeng Deng, Email [sdwanglp@outlook.com](sdwanglp@outlook.com); [yfdeng@126.com](yfdeng@126.com)  \nBackground: Scedosporium aurantiacum is a rare opportunistic pathogen distributed worldwide. S. aurantiacum can cause invasive infections in both immunocompromised and immunocompetent individuals following exposure to contaminated environments. The risk associated with wastewater exposure is an important public health concern. Owing to its multi-drug resistance, the treatment of S. aurantiacum infection is very challenging.  \nCase Presentation: We report a case of a 44-year-old Chinese male with disseminated infection and endocarditis caused by S. aurantiacum after falling into a nearly dry wastewater pool. S. aurantiacum isolated from blood cultures was identified using nanopore sequencing technology of internal transcribed spacer 1 (ITS1) and matrix-assisted laser desorption ionization/time-of-flight mass spectrometry (MALDI-TOF MS) . In vitro antifungal susceptibility testing indicated that voriconazole was the most active agent with a minimum inhibitory concentration (MIC) of 0.5 μg/mL. Despite receiving appropriate antifungal therapy, the patient died 12 days after fungal isolation because of uncontrolled infection and systemic organ failure.  \nConclusion: This is the first reported clinical case of S. aurantiacum endocarditis in China. This case highlights that even in immunocompetent patients, S. aurantiacum infection should be considered. For clinicians, understanding a detailed history of the contaminated environments that the patient has been exposed to is crucial for early diagnosis. Nanopore sequencing offers a new option for identifying S. aurantiacum. Drug susceptibility testing is essential for determining the most appropriate antimycotic agent. Keywords: Scedosporium aurantiacum, immunocompetent patient, disseminated infection, infective endocarditis, nanopore sequencing technology, multi-drug resistance  \nIntroduction  \nScedosporium species are saprophytic filamentous fungi broadly distributed in soil, sewage, and sludge that can cause asymptomatic colonization or localized or disseminated infection in immunocompromised patients, especially following aspiration of contaminated water or traumatic inoculation.1 Scedosporium aurantiacum, one of the main species responsible for scedosporiosis, is a rare and life-threatening opportunistic pathogen that has intrinsic resistance to multiple antifungals, presenting significant challenges to the processes of diagnosis and treatment.2 S. aurantiacum had a high incidence in respiratory specimens of cystic fibrosis patients in Australia, and a relatively low incidence in Europe.3 The clinical isolates of S. aurantiacum from China were described for the first time in 2022,4 but so far there has been no clinical case report of S. aurantiacum endocarditis in China. Herein, we report the fatal case of a previously healthy Chinese patient with disseminated infection and endocarditis, which was found to be caused by S. aurantiacum using fungal culture, MALDI-TOF MS, and nanopore sequencing technology. We also provide a literature review on S. aurantiacum infections.  \nReceived: 30 September 2025  \nAccepted: 12 December 2025  \nPublished: 30 December 2025  \nInfection and Drug Resistance 2025:18 6801–6810 6801  \n© 2025 Liu et al. This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at [https://www.dovepress.com/terms.php](https://www.dovepress.com/terms.php) ","cbCailekJQqI68x5","https://ap.wps.com/l/cbCailekJQqI68x5","pdf",1368795,"English","# Background\n# Case Presentation\n## Clinical presentation and investigations\n## Microbiological identification and susceptibility testing\n# Conclusion\n# Introduction","[{\"question\":\"What exposure likely led to the patient’s infection?\",\"answer\":\"The patient developed disease after falling into a nearly dry wastewater pool, suggesting exposure to contaminated environments.\"},{\"question\":\"How was Scedosporium aurantiacum identified in this case?\",\"answer\":\"The isolate from blood cultures was identified using nanopore sequencing of ITS1 and MALDI-TOF mass spectrometry.\"},{\"question\":\"Which antifungal showed the strongest in vitro activity and what was the outcome?\",\"answer\":\"Voriconazole was the most active agent in vitro (MIC 0.5 μg/mL). Despite appropriate therapy, the patient died 12 days after fungal isolation due to uncontrolled infection and systemic organ failure.\"}]","First Report of Scedosporium aurantiacum Endocarditis in an Immunocompetent Chinese Male and Literature Review | PDF",1790620682,25]