Diagnostic microbiology and infectious disease · 2025
Diagnosis of Cladophialophora bantiana cerebral infection by clinical metagenomics.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Roselli Wanessa Rolando, de Oliveira Miraglia Fernando Franco, de Mello Malta Fernanda, Fernandes Gustavo Bruniera Peres, Ribas Guilherme Carvalhal, de Oliveira Godeiro Júnior Clécio, Amgarten Deyvid Emanuel, Nunes Fabiane Camargo G, Trindade Mario, de Almeida Junior João Nóbrega, Martino Marines Dalla Valle, Santana Rubia Anita Ferraz, Pinho João Renato Rebello, Doi André Mario
Аннотация
PURPOSE: Cladophialophora bantiana is a rare cause of severe central nervous system phaeohyphomycosis.
RESULTS: A 44-year-old woman from Northeastern Brazil with a history of scotomas, mental confusion, and impaired coordination presented Magnetic Resonance Imaging with vasogenic edema and nodular enhancement in the left occipital lobe. Brain biopsy showed neutrophilic exudate with eosinophils, macrophages, giant multinucleated cells, and septate hyphae with a brown-colored birefringent wall and acute angle branching. Metagenomic analysis of the biopsy's total RNA revealed the presence of RNA sequences highly similari to C. bantiana. Culture confirmed the presence of olivaceous-gray suede-like to floccose colonies, with septate dematiaceous hyphae and long conidia chains from undifferentiated conidiophores, consistent with C. bantiana.
CONCLUSIONS: This case highlights the potential of metagenomic testing as a tool for early diagnosis of infections caused by uncommon fungal pathogens. To our knowledge, this is the first report of C. bantiana central nervous system infection in Brazil.
RESULTS: A 44-year-old woman from Northeastern Brazil with a history of scotomas, mental confusion, and impaired coordination presented Magnetic Resonance Imaging with vasogenic edema and nodular enhancement in the left occipital lobe. Brain biopsy showed neutrophilic exudate with eosinophils, macrophages, giant multinucleated cells, and septate hyphae with a brown-colored birefringent wall and acute angle branching. Metagenomic analysis of the biopsy's total RNA revealed the presence of RNA sequences highly similari to C. bantiana. Culture confirmed the presence of olivaceous-gray suede-like to floccose colonies, with septate dematiaceous hyphae and long conidia chains from undifferentiated conidiophores, consistent with C. bantiana.
CONCLUSIONS: This case highlights the potential of metagenomic testing as a tool for early diagnosis of infections caused by uncommon fungal pathogens. To our knowledge, this is the first report of C. bantiana central nervous system infection in Brazil.