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Intracranial necrotizing granuloma caused by Cladophialophora bantiana
Sumit Deb1, A K Khan, B Debasish
1Department of Neurology, NRS Medical College, Kolkata, India. sumit_neuro@yahoo.co.in
Abstract:
The dematiaceous fungi are a group of pigmented hyphal yeasts best known as agents of chronic skin and subcutaneous infections. Extracutaneous disease is exceptional. We report herewith a case of necrotizing granuloma caused by one member of the group, Cladophialophora bantiana. This organism is fully capable of invading the nervous system of apparently immunocompetent hosts and in many cases does so in the absence of demonstrable foci of extraneural infection. It has also been reported to be the most frequently found causative organism in the central nervous system phaeohyphomycosis. C. bantiana has several older names in the literature including Clodosporium trichoides, C. bantianum and Xylohypha bantiana. Patients require treatment with a combination of medical and surgical therapy. Rarity of the case and the usefulness of a simple diagnostic method such as smear cytology, which lead us to the diagnosis, is highlighted by the report.
Insights
This report details a rare case of necrotizing granuloma caused by Cladophialophora bantiana, a fungus typically causing skin infections. The study highlights its potential for nervous system invasion in immunocompetent individuals.
Area of Science:
- Medical Mycology
- Infectious Diseases
- Neurology
Background:
- Dematiaceous fungi are pigmented yeasts primarily causing chronic skin and subcutaneous infections.
- Extracutaneous infections, especially those affecting the central nervous system, are rare for this group.
Observation:
- A case of necrotizing granuloma caused by Cladophialophora bantiana is presented.
- Cladophialophora bantiana is a significant agent of central nervous system phaeohyphomycosis.
- The fungus can invade the nervous system in immunocompetent hosts, often without obvious extraneural infection sites.
Findings:
- Cladophialophora bantiana, also known by synonyms like Xylohypha bantiana, can cause severe, invasive disease.
- Diagnosis was aided by a simple smear cytology method.
- Effective treatment involves a combination of medical and surgical interventions.
Implications:
- Highlights the potential for dematiaceous fungi to cause severe neurological infections.
- Emphasizes the importance of considering rare fungal pathogens in unexplained granulomatous diseases.
- Demonstrates the utility of accessible diagnostic techniques like smear cytology for early detection.
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