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Phaeohyphomycosis Due to Verruconis gallopava: Rare Indolent Pulmonary Infection or Severe Cerebral Fungal Disease?

Mycopathologia

November 2024

Laboratoire de Parasitologie-Mycologie, Service de Parasitologie-Mycologie, AP-HP, Hôpital Saint-Louis, Université Paris-Cité, 1 Avenue Claude Vellefaux, 75010, Paris, France.

Introduction: Phaeohyphomycoses are uncommon and poorly understood opportunistic fungal infections, characterized by a wide spectrum of clinical manifestations ranging from localized skin lesions to disseminated disease. Most frequent genera are Alternaria, Cladophialophora, Exophiala or Curvularia. Less common ones, such as Verruconis gallopava, initially described as responsible of encephalitis of turkeys, pose significant challenges for diagnosis and treatment.

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is a dematiaceous fungi and the most common cause of cerebral phaeohyphomycosis. Here, we report a rare case of cerebral ventriculitis with development of a cerebral abscess due to diagnosed by cell-free DNA next-generation sequencing. Noninvasive diagnostics led to earlier disease identification and initiation of antifungal therapy, which has the potential to reduce mortality in this highly fatal disease.

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Primary cerebral phaeohyphomycosis is a life-threatening disease caused by neurotropic dematiaceous fungi. At present, there are no consensus guidelines regarding optimal antifungal therapy in such cases. Generally, a combination of antifungal agents is recommended for treatment.

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Cerebral phaeohyphomycosis (CP) stands as an exceedingly uncommon yet severe type of fungal infection affecting the central nervous system, attributable to dematiaceous fungi. Despite the patient's immune status, CP is associated with grave prognosis. In the present study, authors describe the first case of left thalamic fungal abscess due to Rhinocladiella mackenziei in an immunocompetent 39-year-old male patient in Jaipur, Rajasthan.

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