Cladophialophora bantiana: a rare cause of fungal brain abscess. Clinical aspects and new therapeutic options

Garzoni, Christian; Markham, Lydia; Bijlenga, Philippe; Garbino, Jorge (2008). Cladophialophora bantiana: a rare cause of fungal brain abscess. Clinical aspects and new therapeutic options. Medical mycology, 46(5), pp. 481-6. Abingdon, UK: Informa UK Ltd 10.1080/13693780801914906

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Black molds or dematiaceous fungi are rare etiologic agents of intracerebral abscesses and such infections carry a high mortality of up to 70% despite combined surgical and antifungal therapy. While the growing use of immunosuppressive therapies and organ transplantation have caused an increase in the incidence of rare fungal cerebral infections, occurrence in immunocompetent hosts is also possible. We describe a 60-year-old female patient with a cerebral abscess caused by Cladophialophora bantiana. The case illustrates the clinical and radiological similarities between glioblastomas and brain abscesses and emphasizes the need to perform histological and microbiological studies prior to the initiation of any form of therapy. Long-term survival from cerebral black mold abscesses has been reported only when complete surgical resection was possible. The recommended antifungal treatment involves the use of amphotericin B combined with a triazole and, if possible, flucytosine. Highly-active new generation triazole antifungal compounds (voriconazole or posaconazole) are likely to offer improved survival rates for patients with rare mold infections. In particular, posaconazole could be a new therapeutic option given its better tolerance, lower toxicity and fewer drug-drug interactions. We discuss clinical, microbiological and practical pharmacological aspects and review current and evolving treatment options.

Item Type:

Journal Article (Further Contribution)

Division/Institute:

04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Infectiology

UniBE Contributor:

Garzoni, Christian

ISSN:

1369-3786

ISBN:

18608882

Publisher:

Informa UK Ltd

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 15:06

Last Modified:

23 Oct 2019 18:48

Publisher DOI:

10.1080/13693780801914906

PubMed ID:

18608882

Web of Science ID:

000258265300011

BORIS DOI:

10.7892/boris.28690

URI:

https://boris.unibe.ch/id/eprint/28690 (FactScience: 125186)

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