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First Fatal Cerebral Phaeohyphomycosis Due to Rhinocladiella Mackenziei in Iran, Based on Its Rdna Publisher Pubmed



Didehdar M1, 2 ; Gokanian A3 ; Sofian M4 ; Mohammadi S5 ; Mohammadi R6 ; Aslani N1 ; Haghani I1 ; Badali H1
Authors
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Authors Affiliations
  1. 1. Department of Medical Mycology and Parasitology, Invasive Fungi Research Center (IFRC), Mazandaran University of Medical Sciences, Sari, Iran
  2. 2. Department of Medical Mycology and Parasitology, Arak University of Medical Sciences, Arak, Iran
  3. 3. Department of Surgery and cerebral, Arak University of Medical Sciences, Arak, Iran
  4. 4. Tuberculosis and pediatric infectious Research Center, Arak University of Medical Sciences, Arak, Iran
  5. 5. Laboratory of Valiaasr Hospital, Arak University of Medical Sciences, Arak, Iran
  6. 6. Department of Medical Parasitology and Mycology, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Source: Journal de Mycologie Medicale Published:2015


Abstract

Black yeast-like fungi and relatives as agents of cerebral phaeohyphomycosis are often encountered in human fatal brain abscesses and lead to almost 100% mortality despite the application of antifungal and surgical therapy. We report to our knowledge the first case of brain infection due to Rhinocladiella mackenziei in a 54-year-old immunocompetent male in Iran where R.mackenziei has not been reported previously. The initial diagnosis was brain fungal infection because of pigmented, irregular, branched, septated hyphae based on histopathological staining. The patient was treated with intravenous amphotericin B deoxycholate (0.5. mg/kg/day) combined with oral itraconazole (200. mg twice daily), nevertheless, his neurological function deteriorated rapidly and ultimately the patient died due to respiratory failure later two weeks. R.mackenziei was identified based on the sequencing of internal transcribed spacer (ITS rDNA region) (KJ140287). Therefore, considerable attention for this life-threatening infection is highly recommended. © 2014 Elsevier Masson SAS.
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