Obstructive hydrocephalus and intracerebral mass secondary to Epicoccum nigrum

Area of Science:

• Mycology
• Neurology
• Infectious Diseases

Background:

• Central nervous system (CNS) infections in neonates pose significant diagnostic and therapeutic challenges.
• Fungal CNS infections are less common than bacterial infections but can have devastating outcomes.
• Identifying the causative fungal species is crucial for targeted treatment and understanding pathogenesis.

Observation:

• A 14-week-old infant presented with irritability and a bulging anterior fontanelle.
• The infant had a history of intrauterine drug exposure and hypoxic ischemic encephalopathy following birth resuscitation.
• Neurosurgical resection revealed fungal hyphae within the CNS tissue.

Findings:

• Fungal Polymerase Chain Reaction (PCR) and sequencing identified *Epicoccum nigrum* as the causative agent.
• This represents the first reported case of a CNS infection attributed to *Epicoccum nigrum*.
• The pathological examination confirmed the presence of fungal elements in the resected tissue.

Implications:

• This case expands the spectrum of known fungal pathogens capable of causing invasive CNS infections.
• Early detection and accurate identification of *Epicoccum nigrum* are critical for appropriate antifungal therapy.
• Further research is warranted to understand the epidemiology and clinical spectrum of *Epicoccum nigrum* infections.