Article

Infections of the central nervous system by melanized fungi: a review of cases presented between 1999 and 2004.

Department of Microbiology and Clinical Microbiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.
Mycoses (Impact Factor: 1.81). 03/2004; 47(1-2):4-13. DOI: 10.1046/j.1439-0507.2003.00956.x
Source: PubMed

ABSTRACT Several types of infections of the central nervous system by melanized fungi can be distinguished: (a) single-organ infection of the cerebrum, (b) extension into the cerebrum from adjacent cavities, (c) fungal presence in the cerebrospinal fluid, or (d) meningitis. The fungal order Chaetothyriales (containing Exophiala-like black yeasts and relatives) is particularly rich in fungi causing cerebral infections. Cases by the main agents, Cladophialophora bantiana, Exophiala dermatitidis, and Ramichloridium mackenziei, published during the last 5 years are reviewed. Most of these infections prove to be fatal. Resection of the lesions in combination with antimycotic therapy may reduce mortality.

0 Bookmarks
 · 
77 Views
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Cerebral phaeohyphomycosis (CP) is a very rare but serious form of central nervous system fungal infection that is caused by dematiaceous fungi. It is commonly associated with poor prognosis irrespective of the immune status of the patient. In this study, the authors describe the first case of CP in Korea that occurred in a 75-year-old man without immunodeficiency and showed favorable outcome after surgical excision and antifungal therapy. In addition, the authors herein review the literature regarding characteristics of this rare clinical entity with previously reported cases.
    Journal of Korean Neurosurgical Society 11/2014; 56(5):444-7. · 0.52 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: A review is given of melanized fungi involved in human infection, including species forming budding cells and strictly filamentous representatives. Classically, they are known as "phaeoid" or "dematiaceous" fungi, and, today, agents are recognized to belong to seven orders of fungi, of which the Chaetothyriales and Pleosporales are the most important. Infections range from cutaneous or pulmonary colonization to systemic or disseminated invasion. Subcutaneous involvement, either primary or after dissemination, may lead to host tissue proliferation of dermis or epidermis. Particularly in the Chaetothyriales, subcutaneous and systemic infections may occur in otherwise apparently healthy individuals. Infections are mostly chronic and require extended antifungal therapy and/or surgery.
    Cold Spring Harbor Perspectives in Medicine 11/2014; · 7.56 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Dematiaceous fungi (black fungi) are a heterogeneous group of fungi present in diverse environments worldwide. Many species in this group are known to cause allergic reactions and potentially fatal diseases in humans and animals, especially in tropical and subtropical climates. This study represents the first survey of dematiaceous fungi in Malaysia and provides observations on their diversity as well as in vitro response to antifungal drugs. Seventy-five strains isolated from various clinical specimens were identified by morphology as well as an internal transcribed spacer (ITS)-based phylogenetic analysis. The combined molecular and conventional approach enabled the identification of three classes of the Ascomycota phylum and 16 genera, the most common being Cladosporium, Cochliobolus and Neoscytalidium. Several of the species identified have not been associated before with human infections. Among 8 antifungal agents tested, the azoles posaconazole (96%), voriconazole (90.7%), ketoconazole (86.7%) and itraconazole (85.3%) showed in vitro activity (MIC ≤1 µg/mL) to the largest number of strains, followed by anidulafungin (89.3%), caspofungin (74.7%) and amphotericin B (70.7%). Fluconazole appeared to be the least effective with only 10.7% of isolates showing in vitro susceptibility. Overall, almost half (45.3%) of the isolates showed reduced susceptibility (MIC >1 µg/mL) to at least one antifungal agent, and three strains (one Pyrenochaeta unguis-hominis and two Nigrospora oryzae) showed potential multidrug resistance.
    PLoS ONE 08/2014; 9(8):e104352. · 3.53 Impact Factor

Preview

Download
1 Download
Available from