Disseminated Pseudallescheria boydii infection in a nonimmunocompromised host

We present a highly unusual case of pulmonary Pseudallescheria boydii infec tion in a nonimmuno-compromised host with a cavitating mass lesion, The dia gnosis was confirmed by open lung biopsy. The patient was treated at anothe r institution with a course of amphotericin B, considered an ineffective th erapy for this infection, and presented to us with direct extension and inv asion of the left atrial appendage and the pulmonary artery, followed by ma ssive pulmonary embolization and hematogenous dissemination to the liver, s pleen, kidney, pancreas, and brain.