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



Didehdar M^{1, 2} ; Gokanian A³ ; Sofian M⁴ ; Mohammadi S⁵ ; Mohammadi R⁶ ; Aslani N¹ ; Haghani I¹ ; Badali H¹
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.