Cerebral chromomycosis

A 52-year-old man was admitted to the hospital with headache, confusion, and early papilledema. He was receiving prednisone and azathioprine for interstitial pulmonary fibrosis. A right temporoparietal cerebral abscess was diagnosed by computed tomographic scan, brain scan, and cerebral angiography. Fungal cultures of pus obtained at operation grew a pigmented fungus, Cladosporium trichoides. Three additional abscesses were found in the right cerebellar hemisphere at autopsy after the patient died of an unrelated cause. Chromomycosis occurring at sites other than skin is extremely rare. No lesions were detected outside the CNS in our patient. C trichoides has not been previously recognized as an agent causing disease in compromised hosts.