Fungal meningoencephalitis caused by Phanerochaete sp.: Case report

We report the first case of fungal meningoencephalitis caused by Phanerochaete sp. in a previously healthy 51-year-old woman. The patient presented with progressive neurological decline and abnormal cerebrospinal fluid (CSF) findings. Neuroimaging suggested fungal infection, but conventional diagnostics were negative. Subsequently, fungal growth was obtained from CSF culture, and the isolate was identified as Phanerochaete sp. by DNA sequencing, an environmental basidiomycete not previously implicated in central nervous system disease. Antifungal therapy with voriconazole and amphotericin B led to mild clinical and radiological improvement, though significant neurological sequelae persisted. This case highlights the value of molecular diagnostics in identifying rare fungal pathogens and expanding our understanding of their pathogenic potential.