Cerebral phaeohyphomycosis—a cure at what lengthsCerebral phaeohyphomycosis—a cure at what lengths.pdf

Review Cerebral phaeohyphomycosis—a cure at what lengths? Dong Ming Li, G Sybren de Hoog Lancet Infect Dis 2009; Cerebral phaeohyphomycosis is a fungal infection of the brain typically caused by Cladophialophora bantiana, 9: 376–83 Exophiala dermatitidis, and Rhinocladiella mackenziei, all of which belong to the order Chaetothyriales. The disease Peking University Third results in black, necrotic brain tissue, black pus, and black cerebrospinal fl uid. Pathogens usually reach the brain Hospital, Beijing, China through the bloodstream or lymphatic fl uid and occasionally through direct spreading or accidental inoculation. (D M Li MD); and Centraalbureau voor Patients can present with hemiparesis, tonic spasm, headache, fever, sensory variation, cerebral irritation, and even Schimmelcultures, Utrecht, psychotic behavioural changes. Radiological images are characterised by ring-enhanced signs and hyperdense and Netherlands (D M Li, hypodense lesions. Pathological features frequently include black-to-brown necrotic tissue or dark-coloured pus, G S de Hoog PhD) granulomatous infl ammation, giant cell vasculitis, and pigmented fungal elements, which are easily seen on a direct Correspondence to: potassium hydroxide smear, a rapid method for diagnosis. Black fungi can be cultured from a biopsy specimen. Dong Ming Li, Peking university third hospital, Dermatology, Combined antifungal chemotherapy, surgical debridement, and careful immunological interventions are strongly No 49 North Huayuan Road, recommended to eradicate these intractable infections. Beijing 100191, China dorisli@126.com Introdu