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Multiple brain abscesses caused by Cladophialophora bantianum: a challenging case

Anuradha Tunuguntla1, Mustafa M Saad, Jehad Abdalla

  • 1Department of Internal Medicine, Quillen College of Medicine, East Tennessee State University, Johnson City, USA.

Tennessee Medicine : Journal of the Tennessee Medical Association
|June 7, 2005
PubMed

Insights

Cladophialophora bantiana, a rare fungus, causes aggressive central nervous system infections with high mortality. This case highlights the challenges in treating this infection, even with combined therapies and surgery.

Area of Science:

  • Medical Mycology
  • Infectious Diseases
  • Neurology

Background:

  • Cladophialophora bantiana is a dematiaceous fungus rarely causing central nervous system infections.
  • This fungus presents an aggressive clinical course with high mortality rates.
  • Treatment options for Cladophialophora bantiana CNS infections are limited and often ineffective.

Observation:

  • A 74-year-old immunocompromised male presented with neurological deficits and multiple ring-enhancing brain lesions on MRI.
  • Stereotactic needle biopsy confirmed Cladophialophora bantiana.
  • The patient exhibited poor response to liposomal amphotericin B monotherapy.

Findings:

  • Combination therapy with flucytosine and voriconazole showed no significant improvement in lesion size.
  • Despite surgical resection of the largest lesion, the patient's condition continued to deteriorate.
  • The case underscores the limited efficacy of current antifungal strategies against this pathogen.

Implications:

  • This case emphasizes the need for novel therapeutic approaches for Cladophialophora bantiana CNS infections.
  • Further research into effective antifungal agents and treatment protocols is crucial.
  • Early diagnosis and aggressive management are vital for improving outcomes in rare fungal CNS infections.

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