Abstract
Central nervous system (CNS) infections caused by brown-black or dematiaceous fungi are distinctly rare and represent a small proportion of infections termed phaeohyphomycoses. However, these are becoming more commonly reported. Though many fungi have been implicated in disease, most cases are caused by only a few species, Cladophialophora bantiana being the most common. Most of the fungi described are molds, and often cause infection in immunocompetent individuals, in contrast to infection with other more common molds such as Aspergillus, which is usually seen in highly immunocompromised patients. Diagnosis is challenging, as there are no specific tests for this group of fungi. In addition, these infections are often refractory to standard drug therapies, requiring an aggressive combined surgical and medical approach to improve outcomes, yet mortality remains high. There are no standardized treatments due to a lack of randomized clinical trials, though guidelines have been published based on available data and expert opinion.
Highlights
Central nervous system (CNS) infections caused by fungi are generally uncommon, and infections due to brown-black or dematiaceous fungi are distinctly rare
Central nervous system infection caused by brown-black fungi most frequently presents as primary brain abscess in immunocompetent individuals, and is one of the most unusual manifestations of phaeohyphomycosis
In 2012, a large outbreak of fungal meningitis occurred in the U.S due to the mold Exserohilum rostratum [2]
Summary
Central nervous system (CNS) infections caused by fungi are generally uncommon, and infections due to brown-black or dematiaceous fungi are distinctly rare. While there have been significant advances in the diagnosis of more common fungal infections due to Candida and Aspergillus, there are no specific diagnostic tests for dematiaceous fungi, adding to the challenge of their management. These infections are often refractory to standard drug therapies, and often require combined surgical and medical therapies [6]. Since these are so infrequently seen in clinical practice, randomized clinical trials are impractical and there is no consensus regarding treatment. We will review the mycologic and clinical aspects of these infections and summarize the available data on management
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
