{"id":"81389f1d-566e-465f-a153-7acfeb2e4fe7","slug":"intracranial-fungal-cladophialophora-bantiana-infection-in-a-nonimmunocompromised-patient-a-case-report-and-review-of-the-literature","title":"Intracranial fungal Cladophialophora bantiana infection in a nonimmunocompromised patient: A case report and review of the literature","authors":["Kent J. Kilbourn","Jaquise Green","Nicholas Zacharewski","Joseph Aferzon","Michael Lawlor","Matthew Jaffa"],"abstract":"Background: Cladophialophora bantiana is a dematiaceous fungus that rarely infects the central nervous system (CNS). It is associated with a mortality rate of over 70% despite treatment. Case Description: An 81-year-old female with a remote history of renal cell carcinoma presented with progressive headache and an expressive aphasia for 3 days. Computed tomography imaging revealed a left frontotemporal mass with surrounding vasogenic edema. A left frontotemporal craniotomy was performed and cultures revealed C. bantiana. The initial management with IV voriconazole was unsuccessful and the patient had a recurrence of the cranial infection and developed pulmonary abscesses. Following the addition of oral flucytosine, the patient showed a significant improvement with a complete radiographic resolution of both the cranial and pulmonary lesions. Conclusion: C. bantiana involving the CNS is a rare and often fatal disease. Surgical management along with standard antifungal treatment may not provide definitive therapy. The addition of flucytosine to IV voriconazole resulted in a positive outcome for this patient who is alive, living independently 1 year from the original diagnosis. In this rare fungal infection, standard antifungal treatment may not provide adequate coverage and the utilization of additional therapy may be required.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/81389f1d-566e-465f-a153-7acfeb2e4fe7/featured/hero-1781561429626.png","publishDate":"2022-04-22T00:00:00.000Z","doi":"10.25259/SNI_116_2022","categories":["Infection","Case Report"],"fullTextUrl":"https://surgicalneurologyint.com/wp-content/uploads/2022/04/11550/SNI-13-165.pdf"}