Cerebral phaeohyphomycosis caused byFonsecaea monophora

In Vitro Activities of Eight Antifungal Drugs against 55 Clinical Isolates of Fonsecaea spp

“…The taxonomy of the genus Fonsecaea has been reviewed recently (12), and on the basis of sequence data, the following three species are recognized: Fonsecaea pedrosoi, Fonsecaea monophora, and Fonsecaea nubica. These species are morphologically identical, but their clinical spectra differ slightly: F. pedrosoi and F. nubica appear to be associated strictly with chromoblastomycosis, whereas F. monophora has also been isolated from brain abscesses, cervical lymph nodes, and bile (4,13,18).…”

“…Several treatment options have been applied, but these tend to result in protracted disease, low cure rates, and frequent relapses (5,9,10,16,18). The therapeutic outcomes are variable and are allegedly dependent on the site of infection, lesion size, the etiological agent, and the patient's health status (4).…”

Fonsecaea pugnacius, a Novel Agent of Disseminated Chromoblastomycosis

“…Although there is no standard antifungal for the treatment of cerebral phaeohyphomycosis, it is generally agreed that a combination of medical and surgical treatment is required (17). Our patient was initially treated with liposomal amphotericin B, followed by oral itraconazole.…”

“…Agents of cerebral infection mostly cause primary cerebral infection, where neurological symptoms are the first indications of infection and spreading from other sites to the brain takes place unnoticed (38). The main neurotropic agents in the Chaetothyriales are Cladophialophora bantiana (39,40), Rhinocladiella mackenziei (41)(42)(43), and Fonsecaea monophora (17). Exophiala dermatitidis is also neurotropic but tends to cause disseminated infections (44).…”

“…In brain tissue, hyphal growth leads to cerebral abscesses and typically to death of the patient. Five cases have been confirmed to have been caused by Fonsecaea monophora (16)(17)(18)(19).…”