Multiple brain abscesses caused by Rhinocladiella mackenziei in an immunocompetent patient: a case report and literature review

Primary cerebral phaeohyphomycosis due to Rhinocladiella mackenziei is an extremely rare infection carrying more than 80% mortality, with most cases reported from the Middle East region. This darkly pigmented black yeast is highly neurotropic, aggressive and refractory to most antifungal agents. Her...

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Bibliographic Details
Published in:Acta neurochirurgica 2017-09, Vol.159 (9), p.1757-1763
Main Authors: Yusupov, Natan, Merve, Ashirwad, Warrell, Clare E, Johnson, Elizabeth, Curtis, Carmel, Samandouras, George
Format: Article
Language:English
Subjects:
Abscesses
Aged
Antifungal agents
Antifungal Agents - therapeutic use
Ascomycota - pathogenicity
Brain
Brain Abscess - drug therapy
Brain Abscess - microbiology
Brain Abscess - surgery
Case Report - Abstract
Case reports
Central Nervous System Fungal Infections - drug therapy
Central Nervous System Fungal Infections - microbiology
Central Nervous System Fungal Infections - surgery
Debridement - methods
Fungicides
Geriatrics
Humans
Immunocompetence
Infections
Interventional Radiology
Intravenous administration
Literature reviews
Male
Medicine
Medicine & Public Health
Minimally Invasive Surgery
Neurology
Neuroradiology
Neurosurgery
Older people
Phaeohyphomycosis
Surgical Orthopedics
Voriconazole
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Description
Summary:Primary cerebral phaeohyphomycosis due to Rhinocladiella mackenziei is an extremely rare infection carrying more than 80% mortality, with most cases reported from the Middle East region. This darkly pigmented black yeast is highly neurotropic, aggressive and refractory to most antifungal agents. Here we present an immunocompetent elderly male, presenting with multiple brain abscesses, with R. mackenziei confirmed by nuclear ribosomal repeat region sequencing, who was successfully treated by surgical debridement and intravenous voriconazole. To our knowledge this is the first case reported from the United Kingdom. We also present a review of all such cases so far reported in the English literature world-wide, which we believe is a step further to understanding the pathogenesis and establishing effective treatment of this rare, yet often fatal disease.
ISSN:0001-6268
0942-0940
DOI:10.1007/s00701-017-3141-0