Cladophialophora bantiana Brain Abscess: A Report of Two Cases Treated with Voriconazole

Gopalakrishnan, Ram; Sethuraman, Nandini; Madhumitha, R; Sukhwani, Kalpesh; Bansal, N.K.; Poojary, Indira; Chakrabarti, Arunaloke

doi:10.4103/ijmm.ijmm_17_72

Cited by 8 publications

(1 citation statement)

References 9 publications

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“…Although the data on therapeutics and prognosis is limited, no single antifungal or combination of antifungals has proven to be effective. Surgical resection in combination with utilization of antifungals with good CSF penetration were associated with better survival [ [8] , [9] , [10] , [11] ]. In this case, the patients’ multiple small abscesses excluded the feasibility of surgical intervention and he received medical treatment alone.…”

Section: Discussionmentioning

confidence: 99%

Cerebral and pulmonary phaeohyphomycosis due Cladophialophora bantiana in an immunocompromised patient

Hernandez

Lawal

2021

IDCases

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We report a case of disseminated Cladophialophora bantiana phaeohyphomycosis with cerebral and pulmonary disease in a 69-year-old renal transplant recipient. The patient presented with confusion, low-grade fever and progressed quickly to a comatose state. Imaging revealed multiple small brain abscesses and a right pulmonary nodule. Cultures of bronchial washings and biopsy of the right pulmonary nodule grew C. bantiana, a highly neurotropic fungus with a high mortality rate. He was treated with Isavuconazonium sulfate (Isavuconazole) and Liposomal Amphotericin B along with reduction immunosuppressive therapy. His neurologic status remained unimproved despite treatment with dual antifungal therapy for two months. The patient eventually died from respiratory failure 79 days after his initial presentation, C. bantiana has been reported in both immunocompetent and immunocompromised patients. Its neurotropism has been reported and described in the literature with C. bantiana responsible for 50 % of the reported cases of fungal brain abscess. However, reports of pulmonary and cerebral involvement are exceedingly rare. Our patient was immunocompromised and succumbed to cerebral involvement.

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