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Murine Renal Transplantation Procedure
18:48

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Published on: July 10, 2009

Brain abscess caused by Cladophialophora (Xylohypha) bantiana in a renal transplant patient

E R Silveira1, M A Resende, V S Mariano

  • 1Department of Nephrology, Hospital Vera Cruz, Federal University of Minas Gerais, Avenida Barbacena 653, 30190-130 Belo Horizonte, Minas Gerais, Brazil. ersilveira@terra.com.br

Transplant Infectious Disease : an Official Journal of the Transplantation Society
|September 17, 2003
PubMed

Insights

A kidney transplant recipient developed a brain abscess caused by the melanized fungus Cladophialophora bantiana. Despite treatment, the infection recurred, leading to fatal Escherichia coli sepsis.

Area of Science:

  • Medical Mycology
  • Infectious Diseases
  • Neurosurgery

Background:

  • Allotransplantation requires heavy immunosuppression, increasing risks of opportunistic infections.
  • Melanized fungi, like Cladophialophora bantiana, can cause rare but severe brain abscesses in immunocompromised patients.

Observation:

  • A 61-year-old kidney transplant recipient presented with hemiparesis.
  • Brain imaging revealed a left parieto-temporal mass, surgically resected as a brown-colored encapsulated abscess.
  • Histopathology and fungal culture confirmed Cladophialophora bantiana.

Findings:

  • The patient experienced a recurrence of the brain abscess despite fluconazole treatment.
  • Subsequent treatment with amphotericin B and surgical intervention did not prevent complications.
  • The patient developed Escherichia coli bacteremia and died from septic shock.

Implications:

  • This case highlights the potential for Cladophialophora bantiana to cause life-threatening brain infections in transplant recipients.
  • Aggressive and potentially multimodal treatment strategies may be necessary for successful management.
  • Early recognition and diagnosis of fungal brain abscesses are crucial in immunocompromised hosts.

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