title: First fatal cerebral phaeohyphomycosis due to Rhinocladiella mackenziei in Iran, based on ITS rDNA.
abstract: Black yeast-like fungi and relatives as agents of cerebral phaeohyphomycosis are often encountered in human fatal brain abscesses and lead to almost 100% mortality despite the application of antifungal and surgical therapy. We report to our knowledge the first case of brain infection due to Rhinocladiella mackenziei in a 54-year-old immunocompetent male in Iran where R. mackenziei has not been reported previously. The initial diagnosis was brain fungal infection because of pigmented, irregular, branched, septated hyphae based on histopathological staining. The patient was treated with intravenous amphotericin B deoxycholate (0.5mg/kg/day) combined with oral itraconazole (200mg twice daily), nevertheless, his neurological function deteriorated rapidly and ultimately the patient died due to respiratory failure later two weeks. R. mackenziei was identified based on the sequencing of internal transcribed spacer (ITS rDNA region) (KJ140287). Therefore, considerable attention for this life-threatening infection is highly recommended.
authors: Department of Medical Mycology and Parasitology/Invasive Fungi Research Center (IFRC), Mazandaran University of Medical Sciences, Sari, Iran; Department of Medical Mycology and Parasitology, Arak University of Medical Sciences, Arak, Iran.
authors: M
authors: M
authors: Didehdar
authors: Department of Surgery and cerebral, Arak University of Medical Sciences, Arak, Iran.
authors: A
authors: A
authors: Gokanian
authors: Tuberculosis and pediatric infectious Research Center, Arak University of Medical Sciences, Arak, Iran.
authors: M
authors: M
authors: Sofian
authors: Laboratory of Valiaasr Hospital, Arak University of Medical Sciences, Arak, Iran.
authors: S
authors: S
authors: Mohammadi
authors: Department of Medical Parasitology and Mycology, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
authors: R
authors: R
authors: Mohammadi
authors: Department of Medical Mycology and Parasitology/Invasive Fungi Research Center (IFRC), Mazandaran University of Medical Sciences, Sari, Iran.
authors: N
authors: N
authors: Aslani
authors: Department of Medical Mycology and Parasitology/Invasive Fungi Research Center (IFRC), Mazandaran University of Medical Sciences, Sari, Iran.
authors: I
authors: I
authors: Haghani
authors: Department of Medical Mycology and Parasitology/Invasive Fungi Research Center (IFRC), Mazandaran University of Medical Sciences, Sari, Iran. Electronic address: badalii@yahoo.com.
authors: H
authors: H
authors: Badali
mesh_terms: D001203:Ascomycota / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D020314:Central Nervous System Fungal Infections / Q000000981:diagnostic imaging / Q000382:microbiology; D060425:Cerebral Phaeohyphomycosis / Q000000981:diagnostic imaging / Q000382:microbiology* / Q000473:pathology; D004271:DNA, Fungal / Q000032:analysis*; D004275:DNA, Ribosomal / Q000032:analysis*; D021903:DNA, Ribosomal Spacer / Q000032:analysis / Q000235:genetics; D017809:Fatal Outcome; D006801:Humans; D007492:Iran; D008297:Male; D008875:Middle Aged; D016533:Mycological Typing Techniques / Q000379:methods; D011859:Radiography
chemical_list: D004271:DNA, Fungal; D004275:DNA, Ribosomal; D021903:DNA, Ribosomal Spacer
keywords: Abcès cérébral; Brain abscess; ITS rADN; ITS rDNA; Iran; R. mackenziei