Central nervous system infections in transplant recipients by Cladophialophora bantiana

Area of Science:

• Medical Mycology
• Infectious Diseases
• Neurosurgery

Background:

• Cladophialophora bantiana is a dematiaceous fungus.
• Historically, it was believed to primarily affect immunocompetent individuals.
• Recent trends indicate a rise in infections among immunocompromised populations.

Observation:

• Dematiaceous fungi, including Cladophialophora, exhibit characteristic golden-brown pigmentation in hyphal walls on histopathology.
• Cladophialophora bantiana displays significant neurotropism compared to other dematiaceous fungi.
• The fungus is increasingly identified as a cause of cerebral abscesses, especially in transplant patients.

Findings:

• This study presents two cases of cerebral abscesses caused by Cladophialophora bantiana in liver and double lung transplant recipients.
• A review of existing literature supports the growing association between this fungus and brain infections in transplant recipients.
• The neurotropic nature of Cladophialophora bantiana is a key factor in its cerebral manifestation.

Implications:

• Highlights the importance of considering Cladophialophora bantiana in the differential diagnosis of brain abscesses in immunocompromised patients, particularly organ transplant recipients.
• Emphasizes the need for accurate histopathological identification of this fungus.
• Suggests a potential shift in the understanding of Cladophialophora bantiana's pathogenicity and host predilection.