A case of central nervous system infection due to Cladophialophora bantiana

A Serda Kantarcioglu; Josep Guarro; G Sybren de Hoog; Hulya Apaydin; Nuri Kiraz; Ilker Inanç Balkan; Resat Ozaras

doi:10.1016/j.riam.2016.01.004

A case of central nervous system infection due to Cladophialophora bantiana

A Serda Kantarcioglu, Josep Guarro, G Sybren de Hoog, Hulya Apaydin, Nuri Kiraz, Ilker Inanç Balkan, Resat Ozaras

Research output: Contribution to journal/periodical › Article › Scientific › peer-review

Abstract

BACKGROUND: Cladophialophora bantiana is a melanised mold with a pronounced tropism for the central nervous system, almost exclusively causing human brain abscesses.

CASE REPORT: We describe a case of cerebral infection by this fungus in an otherwise healthy 28-year-old coal-miner. Environmental occurrence, route of entry, and incubation period of this fungus are unknown, but our case is informative in that the first symptoms occurred about eight weeks after known traumatic inoculation. Lesions were compatible with tuberculous granulomas, and the patient initially received antitubercular treatment. Melanised fungal cells were seen in a brain biopsy and abscess materials. Therapy was switched from empirical antitubercular treatment to amphotericin B (0.5mg/kg/d), but was changed to voriconazole 200mg/d, i.v. on the basis of antifungal susceptibility test results. The patient responded clinically, and gradually improved. The isolate was identified by sequencing of the Internal Transcribed Spacer domain of rDNA.

CONCLUSIONS: Given the non-specific clinical manifestations of C. bantiana cerebral abscesses, clinicians and laboratory workers should suspect infections caused by C. bantiana, particularly in immunocompromised patients with a trauma history.

Original language	English
Journal	Revista Iberoamericana de Micología
DOIs	https://doi.org/10.1016/j.riam.2016.01.004
Publication status	Published - 21 Jul 2016

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title = "A case of central nervous system infection due to Cladophialophora bantiana",

abstract = "BACKGROUND: Cladophialophora bantiana is a melanised mold with a pronounced tropism for the central nervous system, almost exclusively causing human brain abscesses.CASE REPORT: We describe a case of cerebral infection by this fungus in an otherwise healthy 28-year-old coal-miner. Environmental occurrence, route of entry, and incubation period of this fungus are unknown, but our case is informative in that the first symptoms occurred about eight weeks after known traumatic inoculation. Lesions were compatible with tuberculous granulomas, and the patient initially received antitubercular treatment. Melanised fungal cells were seen in a brain biopsy and abscess materials. Therapy was switched from empirical antitubercular treatment to amphotericin B (0.5mg/kg/d), but was changed to voriconazole 200mg/d, i.v. on the basis of antifungal susceptibility test results. The patient responded clinically, and gradually improved. The isolate was identified by sequencing of the Internal Transcribed Spacer domain of rDNA.CONCLUSIONS: Given the non-specific clinical manifestations of C. bantiana cerebral abscesses, clinicians and laboratory workers should suspect infections caused by C. bantiana, particularly in immunocompromised patients with a trauma history.",

author = "Kantarcioglu, {A Serda} and Josep Guarro and {de Hoog}, {G Sybren} and Hulya Apaydin and Nuri Kiraz and Balkan, {Ilker Inan{\c c}} and Resat Ozaras",

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doi = "10.1016/j.riam.2016.01.004",

language = "English",

journal = "Revista Iberoamericana de Micologia",

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T1 - A case of central nervous system infection due to Cladophialophora bantiana

AU - Kantarcioglu, A Serda

AU - Guarro, Josep

AU - de Hoog, G Sybren

AU - Apaydin, Hulya

AU - Kiraz, Nuri

AU - Balkan, Ilker Inanç

AU - Ozaras, Resat

PY - 2016/7/21

Y1 - 2016/7/21

N2 - BACKGROUND: Cladophialophora bantiana is a melanised mold with a pronounced tropism for the central nervous system, almost exclusively causing human brain abscesses.CASE REPORT: We describe a case of cerebral infection by this fungus in an otherwise healthy 28-year-old coal-miner. Environmental occurrence, route of entry, and incubation period of this fungus are unknown, but our case is informative in that the first symptoms occurred about eight weeks after known traumatic inoculation. Lesions were compatible with tuberculous granulomas, and the patient initially received antitubercular treatment. Melanised fungal cells were seen in a brain biopsy and abscess materials. Therapy was switched from empirical antitubercular treatment to amphotericin B (0.5mg/kg/d), but was changed to voriconazole 200mg/d, i.v. on the basis of antifungal susceptibility test results. The patient responded clinically, and gradually improved. The isolate was identified by sequencing of the Internal Transcribed Spacer domain of rDNA.CONCLUSIONS: Given the non-specific clinical manifestations of C. bantiana cerebral abscesses, clinicians and laboratory workers should suspect infections caused by C. bantiana, particularly in immunocompromised patients with a trauma history.

AB - BACKGROUND: Cladophialophora bantiana is a melanised mold with a pronounced tropism for the central nervous system, almost exclusively causing human brain abscesses.CASE REPORT: We describe a case of cerebral infection by this fungus in an otherwise healthy 28-year-old coal-miner. Environmental occurrence, route of entry, and incubation period of this fungus are unknown, but our case is informative in that the first symptoms occurred about eight weeks after known traumatic inoculation. Lesions were compatible with tuberculous granulomas, and the patient initially received antitubercular treatment. Melanised fungal cells were seen in a brain biopsy and abscess materials. Therapy was switched from empirical antitubercular treatment to amphotericin B (0.5mg/kg/d), but was changed to voriconazole 200mg/d, i.v. on the basis of antifungal susceptibility test results. The patient responded clinically, and gradually improved. The isolate was identified by sequencing of the Internal Transcribed Spacer domain of rDNA.CONCLUSIONS: Given the non-specific clinical manifestations of C. bantiana cerebral abscesses, clinicians and laboratory workers should suspect infections caused by C. bantiana, particularly in immunocompromised patients with a trauma history.

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DO - 10.1016/j.riam.2016.01.004

M3 - Article

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JO - Revista Iberoamericana de Micologia

JF - Revista Iberoamericana de Micologia

SN - 1130-1406

ER -

A case of central nervous system infection due to Cladophialophora bantiana

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