title: A case of central nervous system infection due to Cladophialophora bantiana.
abstract: BACKGROUND
  Cladophialophora bantiana is a melanised mold with a pronounced tropism for the central nervous system, almost exclusively causing human brain abscesses.
  
  
  METHODS
  We describe a case of cerebral infection by this fungus in an otherwise healthy 28-year-old coal-miner. Environmental occurrence, route of entry, and incubation period of this fungus are unknown, but our case is informative in that the first symptoms occurred about eight weeks after known traumatic inoculation. Lesions were compatible with tuberculous granulomas, and the patient initially received antitubercular treatment. Melanised fungal cells were seen in a brain biopsy and abscess materials. Therapy was switched from empirical antitubercular treatment to amphotericin B (0.5mg/kg/d), but was changed to voriconazole 200mg/d, i.v. on the basis of antifungal susceptibility test results. The patient responded clinically, and gradually improved. The isolate was identified by sequencing of the Internal Transcribed Spacer domain of rDNA.
  
  
  CONCLUSIONS
  Given the non-specific clinical manifestations of C. bantiana cerebral abscesses, clinicians and laboratory workers should suspect infections caused by C. bantiana, particularly in immunocompromised patients with a trauma history.
authors.affiliation: Mycology Unit, Department of Medical Microbiology, Cerrahpasa Medical Faculty, 34098 Cerrahpasa, Istanbul, Turkey. Electronic address: mycologist1@yahoo.com.
authors.forename: A Serda
authors.initials: AS
authors.lastname: Kantarcioglu
authors.affiliation: Unitat de Microbiologia, Facultat de Medicina i Ciències de la Salut, IISPV, Universitat Rovira i Virgili, E-43201 Reus, Spain.
authors.forename: Josep
authors.initials: J
authors.lastname: Guarro
authors.affiliation: CBS-KNAW Fungal Biodiversity Centre, Utrecht, The Netherlands.
authors.forename: G Sybren
authors.initials: GS
authors.lastname: de Hoog
authors.affiliation: Department of Neurology, Cerrahpasa Medical Faculty, 34098 Cerrahpasa, Istanbul, Turkey.
authors.forename: Hulya
authors.initials: H
authors.lastname: Apaydin
authors.affiliation: Mycology Unit, Department of Medical Microbiology, Cerrahpasa Medical Faculty, 34098 Cerrahpasa, Istanbul, Turkey.
authors.forename: Nuri
authors.initials: N
authors.lastname: Kiraz
authors.affiliation: Department of Infectious Disease and Clinical Bacteriology, Cerrahpasa Medical Faculty, 34098 Cerrahpasa, Istanbul, Turkey.
authors.forename: Ilker Inanç
authors.initials: II
authors.lastname: Balkan
authors.affiliation: Department of Infectious Disease and Clinical Bacteriology, Cerrahpasa Medical Faculty, 34098 Cerrahpasa, Istanbul, Turkey.
authors.forename: Resat
authors.initials: R
authors.lastname: Ozaras
mesh_terms: D000328:Adult; D001203:Ascomycota; D001922:Brain Abscess / Q000382:microbiology*; D006801:Humans; D008297:Male; D016921:Meningitis, Fungal / Q000382:microbiology*
keywords: Absceso cerebral; Brain abscess; Central nervous system infections; Cerebral phaeohyphomycosis; Cladophialophora bantiana; Feohifomicosis cerebral; Fungal meningitis; Infecciones del sistema nervioso central; Meningitis fúngica