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Brain abscesses caused by Cladophialophora bantiana in a lung transplant patient: A case report and review of the literature
Authors:Anthony Gschwend  Tristan Dégot  Julie Denis  Alina M. Sabou  Mi Young Jeung  Emilie Zapata  Michele Porzio  Benjamin Renaud‐Picard  Raoul Herbrecht  Romain Kessler
Affiliation:1. Service de Pneumologie, Nouvel H?pital Civil, H?pitaux Universitaires de Strasbourg, Fédération de Médecine Translationnelle (FMTS), Strasbourg, France;2. Laboratoire de Parasitologie et Mycologie Médicale, Plateau Technique de Microbiologie, H?pitaux Universitaires de Strasbourg, Strasbourg, France;3. Institut de Parasitologie et de Pathologie Tropicale, EA 7292, Fédération de Médecine Translationnelle (FMTS), Université de Strasbourg, Strasbourg, France;4. Service de Radiologie B, Nouvel H?pital Civil, H?pitaux Universitaires de Strasbourg, Strasbourg, France;5. EA 7293 Stress Vasculaire et Tissulaire en Transplantation, Université de Strasbourg, Strasbourg, France;6. Service d'Hématologie et d'Oncologie, H?pital de Hautepierre, H?pitaux Universitaires de Strasbourg, Strasbourg, France
Abstract:Cladophialophora bantiana brain abscesses are rare, but are frequently and quickly lethal in transplanted patients. We report the case of a 63‐year‐old man who had undergone lung transplantation for chronic obstructive pulmonary disease and presented with headaches and a neurological deficit. Magnetic resonance imaging revealed multiple brain abscesses. C. bantiana was identified by DNA sequencing performed directly on cerebral tissue obtained by surgical biopsy. After 6 months of antifungal treatment, the brain abscesses were replaced by ischemic sequelae. The patient died suddenly 2 months later from a pulmonary bacterial infection. This is the second reported case of C. bantiana brain abscesses in a lung transplant recipient, to our knowledge, who experienced a long survival period with medical antifungal treatment alone. We review the literature and discuss our treatment.
Keywords:antifungal treatment  brain abscess     Cladophialophora bantiana     lung transplantation  survival
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