This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrowReprints and Permissions
Right arrow Copyright Information
Right arrow Books from ASM Press
Right arrow MicrobeWorld
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Sutton, D. A.
Right arrow Articles by Rinaldi, M. G.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Sutton, D. A.
Right arrow Articles by Rinaldi, M. G.

 Previous Article  |  Next Article 

Journal of Clinical Microbiology, March 1998, p. 708-715, Vol. 36, No. 3
0095-1137/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.

U.S. Case Report of Cerebral Phaeohyphomycosis Caused by Ramichloridium obovoideum (R. mackenziei): Criteria for Identification, Therapy, and Review of Other Known Dematiaceous Neurotropic Taxa

Deanna A. Sutton,1,* Malcolm Slifkin,2 Robert Yakulis,2 and Michael G. Rinaldi1,3

Fungus Testing Laboratory, Department of Pathology, University of Texas Health Science Center at San Antonio1 and Audie L. Murphy Division, South Texas Veterans Health Care System,3 San Antonio, Texas 78284, and Department of Laboratory Medicine, Allegheny General Hospital, Pittsburgh, Pennsylvania 15212-47722

Received 21 August 1997/Returned for modification 24 October 1997/Accepted 25 November 1997

We report a case of cerebral phaeohyphomycosis in a 36-year-old male caused by the neurotropic fungus Ramichloridium obovoideum (Matushima) de Hoog 1977 (Ramichloridium mackenziei Campbell et Al-Hedaithy 1993). This man resided in the Middle East, where the fungus appears to be endemic and, possibly, geographically restricted, since all previous reports of brain abscesses due to this organism have been for patients indigenous to this area. As a servant of the Saudi Arabian royal family, he appeared in the United States seeking treatment for chronic weight loss, fatigue, decreased memory, and a more recent 2-week history of right-hand weakness which worsened to involve the entire right upper extremity. On the day prior to his admission, he had a focal motor seizure with rotation of the head and eyes to the right, followed by secondary generalization. A computerized tomogram showed a ring-enhancing hypodense lesion in the left parietal subcortical region with associated edema and mass effect. Diagnosis of a fungal etiology was made following a parietal craniotomy and excisional biopsy by observation of septate, dematiaceous hyphal elements 2 to 3 µm in width on hematoxylin-and-eosin-stained sections from within areas of inflammation and necrosis. Culture of the excised material grew out a dematiaceous mould which was subsequently identified as R. obovoideum. At two months postsurgery and with a regimen of 200 mg of itraconazole twice a day, the patient was doing well and returned to Saudi Arabia. His condition subsequently deteriorated, however, and following a 7-month course of itraconzole, he expired. We use this case to alert clinicians and personnel in clinical mycology laboratories of the pathogenicity of this organism and its potential occurrence in patients with central nervous system signs and symptoms who have resided in the Middle East and to review and/or compare R. obovoideum with other neurotropic, dematiaceous taxa and similar nonneurotropic, dematiaceous species.

* Corresponding author. Mailing address: Fungus Testing Laboratory, Department of Pathology, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr., San Antonio, TX 78284-7750. Phone: (210) 567-4131. Fax: (210) 567-4076. E-mail: suttond{at}uthscsa.edu.

Journal of Clinical Microbiology, March 1998, p. 708-715, Vol. 36, No. 3
0095-1137/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.


This article has been cited by other articles:

  • Arzanlou, M., Groenewald, J.Z., Gams, W., Braun, U., Shin, H.-D, Crous, P.W. (2007). Phylogenetic and morphotaxonomic revision of Ramichloridium and allied genera. SIM 58: 57-93 [Abstract] [Full Text]  
  • Barron, M. A., Sutton, D. A., Veve, R., Guarro, J., Rinaldi, M., Thompson, E., Cagnoni, P. J., Moultney, K., Madinger, N. E. (2003). Invasive Mycotic Infections Caused by Chaetomium perlucidum, a New Agent of Cerebral Phaeohyphomycosis. J. Clin. Microbiol. 41: 5302-5307 [Abstract] [Full Text]  
  • Al-Mohsen, I. Z., Sutton, D. A., Sigler, L., Almodovar, E., Mahgoub, N., Frayha, H., Al-Hajjar, S., Rinaldi, M. G., Walsh, T. J. (2000). Acrophialophora fusispora Brain Abscess in a Child with Acute Lymphoblastic Leukemia: Review of Cases and Taxonomy. J. Clin. Microbiol. 38: 4569-4576 [Abstract] [Full Text]  
  • Al-Abdely, H. M., Najvar, L., Bocanegra, R., Fothergill, A., Loebenberg, D., Rinaldi, M. G., Graybill, J. R. (2000). SCH 56592, Amphotericin B, or Itraconazole Therapy of Experimental Murine Cerebral Phaeohyphomycosis Due to Ramichloridium obovoideum ("Ramichloridium mackenziei"). Antimicrob. Agents Chemother. 44: 1159-1162 [Abstract] [Full Text]  
  • Anstead, G. M., Sutton, D. A., Thompson, E. H., Weitzman, I., Otto, R. A., Ahuja, S. K. (1999). Disseminated Zygomycosis Due to Rhizopus schipperae after Heatstroke. J. Clin. Microbiol. 37: 2656-2662 [Abstract] [Full Text]  
  • Cimerman, M., Gunde-Cimerman, N., Zalar, P., Perkovic, T. (1999). Femur Osteomyelitis Due to a Mixed Fungal Infection in a Previously Healthy Man. J. Clin. Microbiol. 37: 1532-1535 [Abstract] [Full Text]  


Copyright © 2009 by the American Society for Microbiology.   For an alternate route to Journals.ASM.org, visit: http://intl-journals.asm.org | More Info»