1. Strain's general data
2. Patient's data
3. Mycological data
Depositor reference number of the isolate *: 
Other collections numbers:
Date of isolation of the strain (dd/mm/yyyy):
Strain cultured from/substrate*:
Name of the depositor*:
Depositor's centre name and address:
Species name given by the depositor*:
Species name given by the Scedosporium group:
Fungal states:
Graphium state present
both state present
cleistothecia present
?
ITS sequence (Paste sequence):
Large subunit rDNA 26-28S (Paste sequence):
General remarks:
Patient's city, country and hospital/ward:
Sex*:
male
unsure
female
?
Race:
Age of patient:
Associated Scedosporium pathology:
Associated Scedosporium pathology remarks:
Date of Scedosporium diagnosis:
Expected format is day/month/year, e.g. 06/01/2009
Predisposing disease(s), factors:
Predisposing disease(s) remarks:
CD4 cells:
Encode a positive numeric value, e.g. 50
Imaging data remarks:
Corticosteroid, Immunosuppressive & Antimicrobial treatments 1 month prior to diagnosis: Drugs, Dosages, Starting and Stopping dates:
Clinical data remarks (fever, neurological and pulmonary signs, ...):
Surgery remarks:
Date of surgery (dd/mm/yyyy):
Expected format is day/month/year, e.g. 06/01/2009
Antifungal treatment of Scedosporium infection: Drugs, Dosages, Starting and Stopping dates:
Outcome of patient after Scedosporium treatment :
Death
Death due to other disease(s)
Cured
?
Outcome date (dd/mm/yyyy):
Expected format is day/month/year, e.g. 06/01/2009
Hyphae in direct microscopy :
Absent
Absent or present
Present
?
Histopathology: organ/biopsy/autopsy:
Antibody detection:
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