Cerebral phaeohyphomycosis caused by Chaetomium globosum in a renal transplant recipient

A 32-year-old male patient developed headaches, vomiting, blurring of vision, and focal seizures of the left side of the face 2 months after a renal transplant. He developed a brain abscess and died. Direct KOH examination of the brain tissue demonstrated hyaline as well as dematiaceous, septate hyphae. Histologic examination of brain sections revealed polymorphous fungal elements consisting of septate, dark-pigmented hyphae, intercalary and terminal swollen fungal cells, and budding yeastlike cells characteristic of phaeohyphomycosis. Chaetomium globosum was isolated from the brain tissue on all of the fungal media used. This case represents the first histologically and culturally documented phaeohyphomycotic brain infection caused by C. globosum.