The typical course of HIV infection for a majority of untreated individuals is persistent viral replication and a gradual loss of CD4 + T cells. One of the consequences of ongoing HIV replication is increased immune activation, aff ecting all major cell populations of the immune system ( 1 -3 ). Within the B cell population, HIV infection has been associated with numerous perturbations ( 4 ), many of which have been attributed to changes in the distribution of B cell subpopulations found in the peripheral blood. These changes include increased frequencies of activated and terminally diff erentiated B cells expressing low levels of CD21 that have been associated with ongoing viral replication ( 5, 6 ), a decreased frequency of memory B cells that is not reversed by antiretroviral therapy ( 7 ), and an increased frequency of immature/transitional B cells that has been associated with CD4 + T cell lymphopenia ( 8, 9 ).The eff ects of immune activation in persistent viral infections have recently been shown to include virus-specifi c T cell exhaustion. After the original description in chronic lymphocyte choriomeningitis virus (LCMV) infection in mice ( 10 ), observations of virus-specifi c CD4 + and CD8 + T cell exhaustion have recently been extended to 12 ). Although PD-1 was the fi rst inhibitory receptor associated with virus-specifi c T cell exhaustion, recent fi ndings suggest that exhaustion may result

SUMMARY Scedosporium spp. are increasingly recognized as causes of resistant life-threatening infections in immunocompromised patients. Scedosporium spp. also cause a wide spectrum of conditions, including mycetoma, saprobic involvement and colonization of the airways, sinopulmonary infections, extrapulmonary localized infections, and disseminated infections. Invasive scedosporium infections are also associated with central nervous infection following near-drowning accidents. The most common sites of infection are the lungs, sinuses, bones, joints, eyes, and brain. Scedosporium apiospermum and Scedosporium prolificans are the two principal medically important species of this genus. Pseudallescheria boydii, the teleomorph of S. apiospermum, is recognized by the presence of cleistothecia. Recent advances in molecular taxonomy have advanced the understanding of the genus Scedosporium and have demonstrated a wider range of species than heretofore recognized. Studies of the pathogenesis of and immune response to Scedosporium spp. underscore the importance of innate host defenses in protection against these organisms. Microbiological diagnosis of Scedosporium spp. currently depends upon culture and morphological characterization. Molecular tools for clinical microbiological detection of Scedosporium spp. are currently investigational. Infections caused by S. apiospermum and P. boydii in patients and animals may respond to antifungal triazoles. By comparison, infections caused by S. prolificans seldom respond to medical therapy alone. Surgery and reversal of immunosuppression may be the only effective therapeutic options for infections caused by S. prolificans.