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Cerebral phaeohyphomycosis: The 'Dark Side' of fungal infections

Archit Latawa1, Ipsita Panda2, Harsimran Kaur3

  • 1Department of Neurosurgery, PGIMER, Chandigarh, India.

Clinical Neurology and Neurosurgery
|February 17, 2022
PubMed
Abstract

Insights

Cerebral phaeohyphomycosis, a rare central nervous system fungal infection, often presents as brain abscesses in immunocompromised individuals and mimics tumors in others. Early diagnosis and treatment are crucial, though outcomes remain poor.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Mycology

Background:

  • Cerebral phaeohyphomycosis is a rare, fatal central nervous system (CNS) infection caused by dematiaceous fungi.
  • Understanding its clinico-radiological presentation, pathology, and outcomes is critical for patient management.

Purpose of the Study:

  • To analyze the clinical, radiological, and pathological features of cerebral phaeohyphomycosis.
  • To evaluate the outcomes of patients diagnosed with this infection.
  • To discuss relevant literature and potential management strategies.

Main Methods:

  • Retrospective review of 7 patients diagnosed with cerebral phaeohyphomycosis between 2014 and 2020.
  • Diagnosis confirmed via KOH mount, fungal cultures, frozen section, or histopathology.
  • Analysis of clinical, radiological, pathological data, and patient outcomes.

Main Results:

  • Three patients had comorbidities (chronic renal failure, hematological malignancy) presenting as brain abscesses.
  • Four immunocompetent patients presented with varied imaging findings, including cystic glioma mimicry and intraventricular tumors.
  • Histopathology revealed microabscesses, gliosis, and inflammation; 6 out of 7 patients died, and one was lost to follow-up.

Conclusions:

  • Cerebral phaeohyphomycosis presents differently in immunocompromised versus immunocompetent patients.
  • KOH mount and frozen sections are effective for early diagnosis.
  • Prognosis is generally poor; early antifungal treatment and aggressive surgical excision may improve outcomes.
Keywords:
AbscessCentral nervous systemFungal infectionPhaeohyphomycosis

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