This case report presents the clinical course of a 58-year-old female renal transplant patient with a complex medical history, including type 2 diabetes mellitus, hypertension, and chronic immunosuppression, who developed a disseminated Nannizziopsis obscura infection. The patient presented with persistent left leg pain and rapidly progressed to multisystem involvement, including central nervous system abscesses. Despite aggressive antifungal therapy and multidisciplinary management, her condition deteriorated, leading to a transition to palliative care. This report highlights the challenges in diagnosing and managing rare fungal infections in immunocompromised patients, highlighting the importance of early detection, advanced imaging, and a coordinated approach to care. The case also emphasizes the ethical considerations in balancing aggressive treatment with quality of life in terminal conditions.
Keywords: brain metastases; end-stage renal disease (esrd); immuno-compromise; nannizziopsis obscura infection; rare fungi; travel history; treatment of brain metastases.
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