Cerebral phaeohyphomycosis caused by Cladophialophora bantiana in a patient with chronic lymphocytic leukemia

Hanieh, S.; Miller, Robert; Daveson, L.; Oman, Kimberly; Norton, Robert

doi:10.1016/j.clinmicnews.2006.06.005

Cited by 3 publications

(6 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There are only limited data in the literature regarding the susceptibility of C. bantiana isolates to antifungals (47). Less successful outcomes of treatment with itraconazole (44) and voriconazole (17,24,49) for cerebral abscesses due to C. bantiana were observed, although itraconazole had low MICs (MIC 90 , 0.125 g/ml) in this study. The explanation might be the less optimal penetration into the CNS.…”

Section: Discussionmentioning

confidence: 46%

“…In animal models, amphotericin B prolonged the survival of mice infected with C. bantiana, but the infection did not completely disappear (1). Although the in vitro activity of amphotericin B against C. bantiana has been demonstrated in this and previous studies, the drug was ineffective in many cases of cerebral phaeohyphomycosis with or without flucytosine (15,19,24,25,40,48,49,52). In vitro results indicate that the amphotericin B MICs for most nondermatophyte opportunistic filamentous fungal isolates clustered between 0.5 and 2 g/ml.…”

Section: Discussionmentioning

confidence: 80%

“…Whereas voriconazole has a good penetration into the CNS, the MICs of C. bantiana were in the higher ranges (MIC 90 , 2 g/ml). Some authors report successful treatment of C. bantiana brain abscesses with voriconazole (38), while others reported clinical failure (17,24,49). Although it is an excellent drug for the treatment of cerebral aspergillosis, voriconazole might not be the first choice for the treatment of C. bantiana infections.…”

Section: Discussionmentioning

confidence: 99%

“…modesta (n ϭ 1) scribed. Patients with bone marrow and solid organ transplantation and patients who are on steroid therapy are particularly affected (2,13,15,24,31,35,36,51,54,57). Cladophialophora bantiana, a neurotropic fungus, has rarely been isolated from sources other than clinical samples.…”

Section: Discussionmentioning

confidence: 99%

“…The most recent series of 48 patients with brain abscess due to C. bantiana showed that 35 patients (72%) had no risk factors and that only 13 patients (28%) survived the infection, despite combined surgical and antifungal treatment (48). The minority of immunocompromised patients are transplant recipients, intravenous drug abusers, or individuals on steroids (2,13,15,24,31,35,36,51,54,57,59).…”

mentioning

confidence: 99%

See 4 more Smart Citations

Use of Amplified Fragment Length Polymorphism To Identify 42 Cladophialophora Strains Related to Cerebral Phaeohyphomycosis with In Vitro Antifungal Susceptibility

et al. 2010

View full text Add to dashboard Cite

The amplified fragment length polymorphism technique has been applied to identify neurotropic chaetothyrialean black yeasts and relatives from clinical sources. Cladophialophora bantiana, C. emmonsii, C. arxii, C. devriesii, and C. modesta, previously identified on the basis of sequencing and phenotypic and physiological criteria, were confirmed by cluster analysis, demonstrating the clear separation of C. bantiana as a rather homogeneous group from the other species. C. bantiana is a neurotropic fungus causing cerebral abscesses with a mortality of up to 70%. Successful therapy consists of neurosurgical intervention and optimal antifungal therapy. Since the latter is not clearly defined in a large series, we tested the in vitro activities of eight antifungal drugs against clinical isolates of C. bantiana (n ‫؍‬ 37), C. modesta (n ‫؍‬ 2), C. arxii (n ‫؍‬ 1), C. emmonsii (n ‫؍‬ 1), and C. devriesii (n ‫؍‬ 1), all of which had caused invasive infections. The resulting MIC 90 s for all neurotropic C. bantiana strains were as follows, in increasing order: posaconazole, 0.125 g/ml; itraconazole, 0.125 g/ml; isavuconazole, 0.5 g/ml; amphotericin B, 1 g/ml; voriconazole, 2 g/ml; anidulafungin, 2 g/ml; caspofungin, 4 g/ml; and fluconazole, 64 g/ml. On the basis of these in vitro results and the findings of previous clinical and animal studies, posaconazole seems to be a good alternative to the standard treatment, amphotericin B, for C. bantiana cerebral infections. The new agent isavuconazole, which is also available as an intravenous preparation, has adequate activity against C. bantiana.

show abstract

Section: Discussionmentioning

confidence: 46%