Article Figures & Data
Figures
- Figure 1
- Radiographic, ventriculoscopic, and histopathological morphologies of Cladophialophora bantiana A) A patient with hydrocephalus due to a brain infection caused by Cladophialophora bantiana. B) Ventriculoscopy revealed extensive ventriculitis, with fungus incorporating the lateral ventricles (arrows). C) Gomori methenamine silver histopathology stain of the brain revealed septate hyphae, and D) fungal culture revealed the characteristic morphology of C. bantiana.
Tables
- Table 1
- Characteristics of phaeohyphomycosis cases at our tertiary hospital in Riyadh, Saudi Arabia.26,31,32*
Case No. Year of Diagnosis Age/ Gender Presenting Symptoms Organism Method of Identification 1 1992 13/M Nausea, vomiting, and coordination impairment Cladophialophora bantiana Histopathology and culture 2* 1998 12/F Seizures Acrophialophora fusispora Histopathology and culture 3 1999 36/M Left hemiplegia Neoscytalidium dimidiatum Histopathology and culture 4 * 2000 62/M Left-sided hemiparesis and hemisensory loss Rhinocladiella mackenziei Histopathology and culture 5 2000 75/M Dizziness and unsteady gait Rhinocladiella mackenziei Histopathology and culture 6 2001 12/M Vomiting Chaetomium atrobrunneum CSF culture 7 2001 18/M Seizure Exophiala dermatitidis Histopathology and culture 8 2005 50/F Seizure Rhinocladiella mackenziei Histopathology and culture 9 2008 70/M Left Hemiparesis Fonsecaea pedrosoi Histopathology and culture 10 2018 31/M Weakness and difficulty in ambulation Rhinocladiella mackenziei Histopathology and culture 11 2018 28/F Eye pain and decreased level of consciousness Exerohilum rostratum Histopathology, culture, and molecular sequencing 12* 2019 55/F Fever and convulsions Neoscytalidium dimidiatum Histopathology, culture, and molecular sequencing F - female, M - male, DM - diabetes mellitus, AmB - Amphotericin B, Vori - Voriconazole, Caspo - Caspofungin, ITZ - Itraconazole, L-AmB -Liposomal Amphotericin B, 5-FC - 5-flourocytocine, KTZ - Ketoconazole, ALL - acute lymphoblastic leukemia, AML - acute myeloid leukemia, MF - myelofibrosis, - Table 1 continued
- Characteristics of phaeohyphomycosis cases at our tertiary hospital in Riyadh, Saudi Arabia.26,31,32*
Case No. Organ Involved Other Than the Brain Underlying Medical Condition Surgery Antifungal Used Outcome at 90 d Duration of antifungal therapy for patients who survived (in months) 1 Disseminated None No AmB, ITZ, Vori, Caspo Died 2* Disseminated ALL Yes AmB, ITR Survived 33 3 Only cerebral Kidney Transplant Yes AmB Died 4 * Cerebral Kidney Transplant Yes AmB, ITZ, Posa Survived 36 5 Cerebral None Yes AmB Died 6 Meninges AML No AmB, ITZ Died 7 Disseminated CGD Yes ITZ, terbinafine, flucytosine Survived Still on treatment 8 Cerebral Kidney transplant Yes Vori, Caspo Died 9 Cerebral Liver Cirrhosis Yes L-AmB, Posa Died 10 Cerebral Liver transplant Yes L-AmB, Posa Died 11 Cerebral and sinuses None/pregnant Yes Caspo, L-Amb, Posa, Vori Survived Still on treatment 12* Cerebral Renal transplant Yes L-AmB, Vori Died F - female, M - male, DM - diabetes mellitus, AmB - Amphotericin B, Vori - Voriconazole, Caspo - Caspofungin, ITZ - Itraconazole, L-AmB -Liposomal Amphotericin B, 5-FC - 5-flourocytocine, KTZ - Ketoconazole, ALL - acute lymphoblastic leukemia, AML - acute myeloid leukemia, MF - myelofibrosis, * *Copyright permission from Al-Abdely HM, Alkhunaizi AM, Al-Tawfiq JA, Hassounah M, Rinaldi MG, Sutton DA. Successful therapy of cerebral Phaeohyphomycosis due to Ramichloridium mackenziei with the new triazole posaconazole. Med Mycol 2005; 43: 91-95.
Al-Mohsen IZ, Sutton DA, Sigler L, Almodovar E, Mahgoub N, Frayha H, et al. Acrophialophora fusispora brain abscess in a child with acute lymphoblastic leukemia: review of cases and taxonomy. J Clin Microbiol 2000; 38: 4569-4576.
Alamri M, Alghamdi H, Althawadi S, Mutabaggani M, Dababo MA, Alajlan F, et al. Invasive fungal infection of the brain caused by Neoscytalidium dimidiatum in a post-renal transplant patient: A case report. Med Mycol Case Rep 2021; 34: 27-31.
Case No. Reference Age/Gender Underlying Condition Surgery Antifungal Outcome 1 14 55 F None Yes AmB, 5-FC, KTZ Died 2 14 80 M None Yes AmB, 5-FC, KTZ Died 3 15 75M None Yes AmB, 5-FC Died 4 14 60M None Yes AmB, 5-FC, KTZ Died 5 16 36M Hodgkin’s Disease Yes ITZ Died 6 18 71 M CML Yes AmB, ITZ Died 7 18 42 M None Yes AmB, ITZ Died 8 19 67 F DM Aspiration AmB Died 9 19 65 F HD Yes AmB Died 10* 23 62M Renal transplant Aspiration LAmB, ITZ, 5-FC then Posa Survived 11 21 66F DM Yes L-AmB, Vori Died 12 22 64F DM Aspiration L-AmB, then Vori+Caspo Died 13 Current 75M None None AmB Died 14 Current 50F Renal transplant Yes Vori, Caspo Died 15 Current 31M Liver transplant Yes AmB, Caspo Died F - female, M - male, DM - diabetes mellitus, AmB - Amphoterecin B, Vori - Voricanazole, Caspo - Caspofungin, ITZ - Itraconazole, L-AmB - liposomal amphotericin B, 5-FC -5-flourocytocine, KTZ - Ketoconazole, *included in the current report
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