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Journal of Clinical Microbiology, September 2008, p. 3152-3155, Vol. 46, No. 9
0095-1137/08/$08.00+0     doi:10.1128/JCM.00800-08
Copyright © 2008, American Society for Microbiology. All Rights Reserved.

CASE REPORT

Fatal-Stroke Syndrome Revealing Fungal Cerebral Vasculitis Due to Arthrographis kalrae in an Immunocompetent Patient {triangledown}

N. Pichon,1,2* D. Ajzenberg,3,4 M. Desnos-Ollivier,5 M. Clavel,1,2 J. C. Gantier,5 and F. Labrousse6

Medical-Surgical Intensive Care Unit, Dupuytren University Hospital, 2 Ave. Martin Luther King, 87042 Limoges Cedex, France,1 Centre Investigation Clinique, Dupuytren University Hospital, Limoges, France,2 Department of Parasitology and Mycology, Dupuytren University Hospital, Limoges, France,3 EA3174-NETEC, Faculty of Medicine, University of Limoges, Limoges, France,4 CNR Mycologie et Antifongiques, Unité de Mycologie Moléculaire, CNRS URA3012, Institut Pasteur, Paris, France,5 Department of Pathology, Dupuytren University Hospital, Limoges, France6

Received 28 April 2008/ Returned for modification 5 July 2008/ Accepted 14 July 2008

We report an uncommon clinical presentation of a unique case of fatal invasive fungal cerebral vasculitis due to Arthrographis kalrae in a nonimmunocompromised host. The identity of the fungus was determined by morphological characteristics and by analysis of internal transcribed spacer 1 sequences and was confirmed by postmortem examination of the brain tissues. Establishing rapidly the link between the clinical syndromes and the fungal infection of the central nervous system is essential to improve the outcome. As our case has shown, it is more challenging to make a diagnosis of fungal infection when there are no risk factors of immunodeficiency and when the clinical presentation seems uncommon.

* Corresponding author. Mailing address: Service de Réanimation Polyvalente, CHU Dupuytren, 2 avenue Martin Luther King, 87042 Limoges, France. Phone: (33) 5 55 05 62 40. Fax: (33) 5 55 05 62 44. E-mail: nicolas.pichon{at}chu-limoges.fr

{triangledown} Published ahead of print on 23 July 2008.

Journal of Clinical Microbiology, September 2008, p. 3152-3155, Vol. 46, No. 9
0095-1137/08/$08.00+0     doi:10.1128/JCM.00800-08
Copyright © 2008, American Society for Microbiology. All Rights Reserved.





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