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Acute meningitis caused by Cladosporium sphaerospermum

Chi-Yu Chen1, Po-Liang Lu, Kun-Mu Lee

  • 1Division of Infectious Diseases (C-YC, P-LL, C-CL, KC, W-RL, C-YL, Y-HC), Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Internal Medicine (C-YC, KC), Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung, Taiwan; Division of Clinical Microbiology (P-LL, K-ML), Department of Laboratory Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; School of Medicine (P-LL, Y-HC), College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Medical Laboratory Science and Biotechnology (CC), College of Medicine, National Cheng Kung University, Tainan, Taiwan; and Graduate Institute of Medicine (C-YL, Y-HC), College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.

The American Journal of the Medical Sciences
|November 23, 2013
PubMed

Insights

Central nervous system phaeohyphomycosis is rare and deadly. This case study details a successful treatment of meningitis caused by Cladosporium sphaerospermum using antifungal chemotherapy, offering hope for rare fungal infections.

Area of Science:

  • Mycology
  • Infectious Diseases
  • Neurology

Background:

  • Phaeohyphomycosis of the central nervous system (CNS) is a rare fungal infection with a high mortality rate.
  • Standardized treatment protocols are lacking, though combined antifungal chemotherapy and surgical intervention are often recommended.
  • Cladosporium species are known opportunistic pathogens, but CNS involvement is exceptionally uncommon.

Observation:

  • A 73-year-old male with well-controlled type 2 diabetes mellitus presented with acute meningitis symptoms, including fever and lower limb weakness.
  • Cranial computed tomography did not reveal any brain abscess.
  • Cerebrospinal fluid analysis led to the isolation and identification of Cladosporium sphaerospermum via morphology and DNA sequencing.

Findings:

  • This case represents the first documented instance of cerebral phaeohyphomycosis caused by Cladosporium sphaerospermum.
  • The patient received a 28-day course of combination antifungal therapy with amphotericin B and voriconazole, followed by 46 days of voriconazole monotherapy.
  • Complete recovery was achieved without significant long-term sequelae.

Implications:

  • Successful treatment of CNS phaeohyphomycosis caused by C. sphaerospermum with a less than three-month antifungal regimen is demonstrated.
  • This case highlights the potential efficacy of targeted antifungal chemotherapy in managing rare CNS fungal infections.
  • Early diagnosis and prompt treatment are crucial for improving outcomes in patients with CNS phaeohyphomycosis.

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