Brain abscesses caused by Cladophialophora bantiana in a lung transplant patient: A case report and review of the literature

Transpl Infect Dis. 2017 Dec;19(6). doi: 10.1111/tid.12787. Epub 2017 Nov 7.

Abstract

Cladophialophora bantiana brain abscesses are rare, but are frequently and quickly lethal in transplanted patients. We report the case of a 63-year-old man who had undergone lung transplantation for chronic obstructive pulmonary disease and presented with headaches and a neurological deficit. Magnetic resonance imaging revealed multiple brain abscesses. C. bantiana was identified by DNA sequencing performed directly on cerebral tissue obtained by surgical biopsy. After 6 months of antifungal treatment, the brain abscesses were replaced by ischemic sequelae. The patient died suddenly 2 months later from a pulmonary bacterial infection. This is the second reported case of C. bantiana brain abscesses in a lung transplant recipient, to our knowledge, who experienced a long survival period with medical antifungal treatment alone. We review the literature and discuss our treatment.

Keywords: Cladophialophora bantiana; antifungal treatment; brain abscess; lung transplantation; survival.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Antifungal Agents / therapeutic use
  • Ascomycota / isolation & purification*
  • Biopsy
  • Brain / diagnostic imaging
  • Brain / pathology
  • Brain Abscess / diagnostic imaging
  • Brain Abscess / drug therapy
  • Brain Abscess / microbiology*
  • Brain Abscess / pathology
  • Central Nervous System Fungal Infections
  • Fatal Outcome
  • Humans
  • Hyphae / isolation & purification
  • Lung Transplantation / adverse effects*
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Pulmonary Disease, Chronic Obstructive / surgery*
  • Time Factors

Substances

  • Antifungal Agents