Multiple brain abscesses caused by
1: Tenn Med. 2005 May;98(5):227-8, 235.
Multiple brain abscesses caused by Cladophialophora bantianum: a
Tunuguntla A, Saad MM, Abdalla J, Myers JW.
Department of Internal Medicine, Quillen College of Medicine,
East Tennessee State University, Johnson City, USA.
Cladophialophora bantianum, a dematiaceous fungus with dark
pigmented hyphae, is a rare cause of central nervous system
(CNS) infection. This aggressive mold has a high mortality rate,
primarily related to its poor response to currently available
antifungal therapy. In this article, we report a 74-year-old
immunocompromised man who presented with left-sided weakness,
sensory deficit, and an abnormal magnetic resonance imaging (MRI)
of the brain, which showed multiple ring-enhancing cerebral
lesions. The largest lesion measured 4.6 x 3.9 centimeters and
was located within the parietal region. He underwent a
stereotactic needle biopsy, revealing a pigmented fungus which
subsequently grew Cladophialophora bantiana. The patient failed
initial monotherapy with liposomal amphotericin B. Later in the
patient's hospital course, Flucytosine and voriconazole were
added but there was no significant change in the size of the
lesions on a repeat brain MRI performed one month into therapy.
Surgical resection of the largest lesion was performed.
Nevertheless, he continued to deteriorate and therapy was
withheld per family request.