Cerebral phaeohyphomycosis due to Cladophialophora bantiana: case report and systematic review of cases.

Amphotericin B Antifungal treatment Brain abscess Cladophialophora Melanized fungus Phaeohyphomycosis

Journal

Infection
ISSN: 1439-0973
Titre abrégé: Infection
Pays: Germany
ID NLM: 0365307

Informations de publication

Date de publication:
Apr 2024
Historique:
received: 28 08 2023
accepted: 26 10 2023
pubmed: 18 11 2023
medline: 18 11 2023
entrez: 18 11 2023
Statut: ppublish

Résumé

Cladophialophora bantiana is a wonted melanized fungus causing brain abscess. In past many cases were reported from Asia, particularly from India. Of late, there is a rise in cases in places besides Asia and hence a review of the cases is warranted. We present a case of fatal cerebral phaeohyphomycosis caused by C. bantiana and conduct a systematic review of culture confirmed brain abscess due to C. bantiana reported between 2015 and 2022. Of the 39 cases found, majority (68%) were immunocompromised. The various clinical presentations were headache (53%), hemiparesis (34%), visual disturbance (25%), altered sensorium (18%), aphasia/dysarthria (12%) and seizures (9%). Isolated lesion was observed in 18 (60%) patients. In the sequence of occurrence, the lesions were in frontal (30%), temporal (27%) and parietal (20%) region. There were five cases with coinfections such as concurrent detection of Nocardia pneumonia in two cases, toxoplasma DNA in brain abscess, coexisting pulmonary Cryptococcus neoformans infection and coexisting Candida in a case of brain abscess in one case each. Surgical intervention was performed in 84% cases. Antifungal therapy included voriconazole (80%), liposomal amphotericin B (76%), 5-fluorocytosine (30%), posaconazole (10%), and amphotericin B deoxycholate (6%). The overall mortality was 50% with lower mortality (42%) in regions outside Asia compared to Asia (63.6%) though not statistically significant. C. bantiana brain abscess is an emerging infection worldwide. Next generation sequencing is an upcoming promising diagnostic test. Early complete excision of the lesion with effective antifungals may improve the outcome.

Identifiants

pubmed: 37979132
doi: 10.1007/s15010-023-02126-4
pii: 10.1007/s15010-023-02126-4
doi:

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

313-321

Informations de copyright

© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.

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Auteurs

Vithiya Ganesan (V)

Velammal Medical College Hospital and Research Institute, Madurai, India. vidhya.md@gmail.com.

Vinaykumar Hallur (V)

All India Institute of Medical Sciences Bhubaneswar, Bhubaneswar, India.

S Velvizhi (S)

Velammal Medical College Hospital and Research Institute, Madurai, India.

T Rajendran (T)

Velammal Medical College Hospital and Research Institute, Madurai, India.

Classifications MeSH