First report of fungal meningoencephalitis by Penicillium chrysogenum in Brazil

• Published in: International journal of infectious diseases 2023-01, Vol.126, p.94-97
• Main Authors: de Oliveira, Rômulo Vieira Mello, Corrêa-Moreira, Danielly, Mendes, Túlio Vieira, da Costa, Gisela Lara, Vieira, Renata de Magalhães, Buchele, Cynthia Miranda Nascimento, Lins, Rodrigo Schrage, Ferreira, Ana Beatriz Teixeira Brandão Camello, Veira, Daniela Barbosa, Pedroso, Rafael Santos de Aragão, de Faria, Vinícius Tadeu Dias Pereira, Oliveira, Manoel Marques Evangelista
• Format: Article
• Language: English
• Subjects: Brazil - epidemiology; Fungal infections; Humans; Immunocompetent patient; Meningitis; Meningoencephalitis; Meningoencephalitis - diagnosis; Meningoencephalitis - drug therapy; Mycoses; Penicillium; Penicillium - genetics; Penicillium chrysogenum; Penicillium chrysogenum - genetics
• ISSN: 1201-9712; 1878-3511
• DOI: 10.1016/j.ijid.2022.11.015

•The first case of meningoencephalitis-associated Penicillium spp.•Case report of brain injury caused by Penicillium chrysogenum in a patient who is immunocompetent.•The need for studies to determine treatment for severe forms of invasive infections. Fungal infections of the central nervous system present a variety of clinical syndromes, such as meningitis, encephalitis, raised intracranial pressure with a nonspecific presentation, and, in the last two decades, have increased the incidence of these fungal infections. Fungal meningoencephalitis is frequently associated with Cryptococcus, but this report stands out for presenting one species of Penicillium genus. Here, we present the first case of meningoencephalitis associated with brain injury caused by Penicillium chrysogenum, in a patient who is immunocompetent and was admitted to Hospital Naval Marcílio Dias, Rio de Janeiro, Brazil. To identify the fungal species, we performed phenotypic and genotypic methodologies, from the culture to the sequencing of internal transcribed spacer region, and β-tubulin gene, a rare fungus in cerebrospinal fluid cultures, belonging to the genus Penicillium, was identified. We highlight the importance of the first report of meningoencephalitis caused by P. chrysogenum in a patient who is immunocompetent, registered in Brazil. We also emphasize the need for further studies to determine an effective treatment with the least possible side effects for patients infected by fungi that are rarely related to the most severe forms of invasive infections. [Display omitted]