Related Experiment Video
Updated: Sep 14, 2026
Isolation and Flow Cytometric Analysis of Glioma-infiltrating Peripheral Blood Mononuclear Cells
Published on: November 28, 2015
Utility of liquid biopsy in diagnosing isolated cerebral phaeohyphomycosis: illustrative case
Annie E Arrighi-Allisan1, Monica M Vidaurrazaga2, Vincent B De Chavez2
1Departments of1Medical Education and.
Background:
Cladophialophora bantiana is a dematiaceous, saprophytic fungus and a rare but reported cause of intracranial abscesses due to its strong neurotropism. Although it predominantly affects immunocompetent individuals with environmental exposure, more recently, its significance as a highly lethal opportunistic infection in transplant recipients has been recognized. Successful treatment requires timely but often challenging diagnosis, followed by complete surgical excision. Next-generation sequencing of microbial cell-free DNA (cfDNA) from plasma is a novel diagnostic method with the potential to identify invasive fungal infections more rapidly and less invasively than conventional microbiological testing, including brain biopsy.
Observations:
The authors described the case of a recipient of a liver transplant who presented with seizures and was found to have innumerable ring-enhancing intracranial lesions. The Karius Test, a commercially available method of next-generation sequencing of cfDNA, was used to determine the causative organism. Samples from the patient's plasma identified C. bantiana 6 days before culture results of the surgical specimen, allowing optimization of the empirical antifungal regimen, which led to a reduction in the size of the abscesses.
Lessons:
The authors' findings suggest that microbial cfDNA sequencing may be particularly impactful in improving the management of brain abscesses in which the differential diagnosis is wide because of immunosuppression.
Insights
Next-generation sequencing of cell-free DNA (cfDNA) rapidly identified Cladophialophora bantiana in a liver transplant recipient with brain abscesses. This novel diagnostic approach enabled earlier targeted antifungal therapy, improving patient outcomes.
Area of Science:
- Mycology
- Infectious Diseases
- Transplant Medicine
Background:
- Cladophialophora bantiana is a rare fungus causing intracranial abscesses, particularly in immunocompromised individuals.
- While traditionally affecting immunocompetent hosts, it's increasingly recognized as a lethal opportunistic infection in transplant recipients.
- Effective management hinges on prompt diagnosis and surgical intervention, which can be challenging.
Purpose of the Study:
- To evaluate the utility of next-generation sequencing of microbial cell-free DNA (cfDNA) for diagnosing invasive fungal infections.
- To assess the impact of cfDNA sequencing on the management of brain abscesses in transplant recipients.
Main Methods:
- Case report of a liver transplant recipient presenting with intracranial lesions.
- Utilized the Karius Test, a commercial next-generation sequencing method for cfDNA analysis.
- Compared cfDNA sequencing results with conventional microbiological testing.
Main Results:
- Plasma cfDNA sequencing identified Cladophialophora bantiana six days prior to surgical specimen culture results.
- This early identification allowed for optimization of antifungal therapy.
- The optimized regimen led to a reduction in the size of intracranial abscesses.
Conclusions:
- Microbial cfDNA sequencing offers a rapid and less invasive diagnostic alternative for invasive fungal infections.
- This technology may significantly improve the management of brain abscesses in immunosuppressed patients with broad differential diagnoses.
