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Fatal brain abscesses caused by Ramichloridium obovoideum: report of three cases
Naim-ur-Rahman1, E S Mahgoub, A H Chagla
1Department of Neurosurgery, Federal Postgraduate Medical Institute, Shaikh Zayed Hospital, Lahore, Pakistan.
Abstract:
Three cases of brain abscesses caused by Ramichloridium obovoideum are reported. Inspite of adequate antifungal chemotherapy and multiple surgical procedures, all the three patients died of the rupture of a recurrant abscess into the ventricles. Ramichloridium obovoideum was identified as the causative fungus of these brain abscesses. Clinical, histological and mycological features of these cases are described. To our knowledge this is the first time that this fungus is isolated from a brain abscess in Saudi Arabia. The possibility that this life threatening cerebral mycosis may be endemic in this part of the world is considered.
Insights
Three patients with brain abscesses caused by Ramichloridium obovoideum died despite treatment. This fungal infection, Ramichloridium obovoideum, may be endemic in Saudi Arabia.
Area of Science:
- Mycology
- Neurology
- Infectious Diseases
Background:
- Brain abscesses are serious intracranial infections.
- Fungal brain abscesses are rare but carry a high mortality rate.
- Ramichloridium obovoideum is a fungus not commonly associated with human infections.
Observation:
- Three cases of brain abscesses caused by Ramichloridium obovoideum are presented.
- Despite antifungal chemotherapy and surgical interventions, all patients experienced recurrent abscesses.
- Rupture of recurrent abscesses into the ventricles led to fatal outcomes in all three cases.
Findings:
- Ramichloridium obovoideum was identified as the causative agent in all three brain abscess cases.
- Clinical, histological, and mycological features of these infections were documented.
- This marks the first reported isolation of Ramichloridium obovoideum from brain abscesses in Saudi Arabia.
Implications:
- The findings suggest Ramichloridium obovoideum as a potential cause of cerebral mycosis.
- The high mortality rate highlights the aggressive nature of these infections.
- The possibility of this life-threatening cerebral mycosis being endemic in Saudi Arabia warrants further investigation.