Cerebral phaeohyphomycosis caused by Cladophialophora bantiana in a patient with chronic lymphocytic leukemia

The phaeohyphomycoses are infections caused by dematiaceous fungi. The dark pigmentation results from the melanin in their cell walls, which may be one of the factors responsible for the virulence and pathogenic potential of these fungi (1). Cladophialophora bantiana is highly neurotropic and accounts for the majority of cases of cerebral phaeohyphomycosis. Unlike many of the opportunistic fungi, most reported cases of cerebral phaeohyphomycosis caused by C. bantiana have occurred in immunocompetent patients. C. bantiana infection is often reported as being resistant to conventional medical therapy and as having an overall poor prognosis, regardless of immune status. Medical therapy is not standardized, and clinical experience with the newer azoles, such as voriconazole, has been limited.