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Cladophialophora bantiana brain abscess with lymphadenitis

Vinit Suri1, Shishir Pandey2, Nidhi Goyal3

  • 1Neurology, Indraprastha Apollo Hospital, New Delhi, India vinitsuri@hotmail.com.

BMJ Case Reports
|October 28, 2021
PubMed

Insights

Cerebral phaeohyphomycosis, a central nervous system infection caused by dark fungi, can lead to brain abscesses. Early diagnosis of Cladophialophora bantiana brain abscesses is possible with MR spectroscopy and lymph node biopsy.

Area of Science:

  • Mycology
  • Infectious Diseases
  • Neurology

Background:

  • Cerebral phaeohyphomycosis is a central nervous system (CNS) infection caused by dematiaceous fungi, characterized by melanin in their cell walls, contributing to virulence.
  • These infections manifest as sinusitis, brain abscess, meningitis, myelitis, and arachnoiditis, posing diagnostic challenges.

Observation:

  • Cladophialophora bantiana is the most frequent cause of brain abscesses in both immunocompetent and immunocompromised individuals, with a global distribution, particularly in subtropical regions like the Asian subcontinent.
  • Radiological differentiation of these abscesses from high-grade gliomas, primary CNS lymphoma, toxoplasmosis, nocardiosis, tuberculosis, and listeriosis is difficult.

Findings:

  • A case report details a 19-year-old male with a cerebral abscess caused by C. bantiana.
  • Typical Magnetic Resonance (MR) spectroscopic findings aided in suspecting the diagnosis.
  • Identification of the fungus from a lymph node biopsy confirmed the diagnosis.

Implications:

  • This case highlights the utility of MR spectroscopy in the early suspicion of C. bantiana brain abscesses.
  • Lymph node biopsy can be a valuable diagnostic tool for identifying the causative fungus.
  • Improved diagnostic strategies are crucial for timely and effective management of cerebral phaeohyphomycosis.
Keywords:
infection (neurology)radiologytropical medicine (infectious disease)

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