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Cerebral chromomycosis

F A Salem, D W Kannangara, R Nachum

    Archives of Neurology
    |March 1, 1983
    PubMed

    Insights

    A rare fungal brain infection caused by Cladosporium trichoides occurred in an immunocompromised patient. This case highlights the potential for chromomycosis to affect the central nervous system, even in non-skin sites.

    Area of Science:

    • Mycology
    • Neurology
    • Infectious Diseases

    Background:

    • A 52-year-old male patient with interstitial pulmonary fibrosis was on immunosuppressive therapy (prednisone and azathioprine).
    • The patient presented with neurological symptoms including headache, confusion, and papilledema.

    Observation:

    • Diagnostic imaging (CT scan, brain scan, cerebral angiography) revealed a right temporoparietal cerebral abscess.
    • Surgical pus culture identified the causative agent as Cladosporium trichoides, a pigmented fungus.

    Findings:

    • The patient developed multiple cerebral abscesses, with three additional lesions found in the right cerebellar hemisphere at autopsy.
    • Cladosporium trichoides, typically associated with chromomycosis, caused central nervous system disease in this immunocompromised host.
    • No extraneural lesions were detected, indicating a rare presentation of CNS-specific chromomycosis.

    Implications:

    • This case expands the known spectrum of Cladosporium trichoides infections, particularly in immunocompromised individuals.
    • It underscores the importance of considering fungal infections, including chromomycosis, in the differential diagnosis of central nervous system lesions in immunosuppressed patients.
    • Further research is needed to understand the pathogenesis and optimal treatment strategies for CNS chromomycosis in compromised hosts.

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