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Brain abscess caused by Cladosporium trichoides (Bantianum): a case with paranasal sinus involvement

J W Brown, J Nadell, C V Sanders

    Southern Medical Journal
    |November 1, 1976
    PubMed

    Insights

    Dematiacious fungi, like Cladosporium trichoides, rarely cause fatal central nervous system infections. This case highlights potential flucytosine efficacy for brain infections, even with extra-CNS involvement.

    Area of Science:

    • Mycology
    • Infectious Diseases
    • Neurology

    Background:

    • Dematiacious fungi, characterized by dark hyphae, are infrequent but severe causes of central nervous system (CNS) infections.
    • Cladosporium trichoides is the most commonly identified dematiacious fungus implicated in CNS disease.
    • Instances of Cladosporium trichoides causing infections outside the CNS are seldom reported.

    Observation:

    • A patient presented with a brain abscess and a concurrent paranasal sinus infection.
    • The causative agent identified for both infections was Cladosporium trichoides.
    • Laboratory testing revealed that the Cladosporium trichoides isolate was susceptible to low concentrations of flucytosine (≤ 2 μg/ml).

    Findings:

    • This case documents simultaneous central nervous system and paranasal sinus infection by Cladosporium trichoides.
    • The susceptibility of the organism to flucytosine suggests a potential therapeutic avenue.

    Implications:

    • Flucytosine, known for its good penetration into cerebrospinal fluid, may represent a viable treatment option for cerebral cladosporiosis.
    • Further investigation into flucytosine's role in treating CNS dematiacious fungal infections is warranted.
    • This case underscores the importance of considering extra-CNS sites in diagnosing and managing fungal brain infections.

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