A case of multiple cerebral abscesses due to infection with Cladophialophora bantiana

Roche, M.; Redmond, R M; O’Neill, Shane; Smyth, E.G.

doi:10.1016/j.jinf.2005.02.029

Cited by 30 publications

(22 citation statements)

References 11 publications

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“…There are only limited data in the literature regarding the susceptibility of C. bantiana isolates to antifungals (47). Less successful outcomes of treatment with itraconazole (44) and voriconazole (17,24,49) for cerebral abscesses due to C. bantiana were observed, although itraconazole had low MICs (MIC 90 , 0.125 g/ml) in this study. The explanation might be the less optimal penetration into the CNS.…”

Section: Discussioncontrasting

confidence: 57%

“…In animal models, amphotericin B prolonged the survival of mice infected with C. bantiana, but the infection did not completely disappear (1). Although the in vitro activity of amphotericin B against C. bantiana has been demonstrated in this and previous studies, the drug was ineffective in many cases of cerebral phaeohyphomycosis with or without flucytosine (15,19,24,25,40,48,49,52). In vitro results indicate that the amphotericin B MICs for most nondermatophyte opportunistic filamentous fungal isolates clustered between 0.5 and 2 g/ml.…”

Section: Discussionmentioning

confidence: 72%

“…Whereas voriconazole has a good penetration into the CNS, the MICs of C. bantiana were in the higher ranges (MIC 90 , 2 g/ml). Some authors report successful treatment of C. bantiana brain abscesses with voriconazole (38), while others reported clinical failure (17,24,49). Although it is an excellent drug for the treatment of cerebral aspergillosis, voriconazole might not be the first choice for the treatment of C. bantiana infections.…”

Section: Discussionmentioning

confidence: 99%

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Use of Amplified Fragment Length Polymorphism To Identify 42 Cladophialophora Strains Related to Cerebral Phaeohyphomycosis with In Vitro Antifungal Susceptibility

et al. 2010

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The amplified fragment length polymorphism technique has been applied to identify neurotropic chaetothyrialean black yeasts and relatives from clinical sources. Cladophialophora bantiana, C. emmonsii, C. arxii, C. devriesii, and C. modesta, previously identified on the basis of sequencing and phenotypic and physiological criteria, were confirmed by cluster analysis, demonstrating the clear separation of C. bantiana as a rather homogeneous group from the other species. C. bantiana is a neurotropic fungus causing cerebral abscesses with a mortality of up to 70%. Successful therapy consists of neurosurgical intervention and optimal antifungal therapy. Since the latter is not clearly defined in a large series, we tested the in vitro activities of eight antifungal drugs against clinical isolates of C. bantiana (n ‫؍‬ 37), C. modesta (n ‫؍‬ 2), C. arxii (n ‫؍‬ 1), C. emmonsii (n ‫؍‬ 1), and C. devriesii (n ‫؍‬ 1), all of which had caused invasive infections. The resulting MIC 90 s for all neurotropic C. bantiana strains were as follows, in increasing order: posaconazole, 0.125 g/ml; itraconazole, 0.125 g/ml; isavuconazole, 0.5 g/ml; amphotericin B, 1 g/ml; voriconazole, 2 g/ml; anidulafungin, 2 g/ml; caspofungin, 4 g/ml; and fluconazole, 64 g/ml. On the basis of these in vitro results and the findings of previous clinical and animal studies, posaconazole seems to be a good alternative to the standard treatment, amphotericin B, for C. bantiana cerebral infections. The new agent isavuconazole, which is also available as an intravenous preparation, has adequate activity against C. bantiana.

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Section: Discussioncontrasting

confidence: 57%

Section: Discussionmentioning

confidence: 72%

Section: Discussionmentioning

confidence: 99%

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Use of Amplified Fragment Length Polymorphism To Identify 42 Cladophialophora Strains Related to Cerebral Phaeohyphomycosis with In Vitro Antifungal Susceptibility

et al. 2010

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“…Mortality was Ͼ70%. Since that review in 2004, over 50 cases have been reported, with C. bantiana remaining the most frequently seen isolate (131,4,17,16,22,31,40,70,78,93,121,139,170,189,243,244,268,272,276,328,332,341,363,380,399,420,433,448,450,467,476,545,575,636,657,696,700,721,731,733,754,759). A new species, Fonsecaea monophora, has been reported since that time and appears to have a predilection for causing CNS disease, in contrast to its related species, F. pedrosoi (420,721,733).…”

Section: Phaeohyphomycosismentioning

confidence: 99%

Melanized Fungi in Human Disease

2010

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SUMMARY Melanized or dematiaceous fungi are associated with a wide variety of infectious syndromes. Many are soil organisms and are generally distributed worldwide, though certain species appear to have restricted geographic ranges. Though they are uncommon causes of disease, melanized fungi have been increasingly recognized as important pathogens, with most reports occurring in the past 20 years. The spectrum of diseases with which they are associated has also broadened and includes allergic disease, superficial and deep local infections, pneumonia, brain abscess, and disseminated infection. For some infections in immunocompetent individuals, such as allergic fungal sinusitis and brain abscess, they are among the most common etiologic fungi. Melanin is a likely virulence factor for these fungi. Diagnosis relies on careful microscopic and pathological examination, as well as clinical assessment of the patient, as these fungi are often considered contaminants. Therapy varies depending upon the clinical syndrome. Local infection may be cured with excision alone, while systemic disease is often refractory to therapy. Triazoles such as voriconazole, posaconazole, and itraconazole have the most consistent in vitro activity. Further studies are needed to better understand the pathogenesis and optimal treatment of these uncommon infections.

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“…bantiana is a fungus that is darkly pigmented because of melanin in the septated hyphae cell wall [1][2][3][4]. Former names for C. bantiana include Xylophypha emmonsii, Xylophypha bantiana, Cladosporium bantianum, and Cladosporium trichoides [5].…”

mentioning

confidence: 99%