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Peer-reviewedCC BY 4.0IDCases

Primary cerebral pheohyphomycosis in an immunocompetent adult: A case report and review of the literature

  • Hani Hamad1
  • Mohammed Abu Khattab1
  • Husam Eldin Salah2
  • Ali Omrani1
  • Sreethish Sasi1
  • Muna Al Maslamani1
  1. 1Infectious disease, Department of Internal Medicine, Hamad Medical Corporation, Doha, Qatar
  2. 2Division of Microbiology, Department of Laboratory Medicine & Pathology, Hamad Medical Corporation, Doha, Qatar
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Abstract

Cerebral pheohyphomycosis is a rare, life-threatening central nervous system infection caused by dematiaceous fungi. It predominantly affects immunocompromised individuals; however, cases in immunocompetent hosts have been increasingly reported, particularly in association with environmental exposure. The diagnosis is challenging due to nonspecific clinical manifestations and radiological features that often mimic neoplastic or bacterial lesions. We report the case of a previously healthy 45-year-old Kenyan male who presented with chronic headache and progressive neurological deficits. Neuroimaging revealed multiple intracranial lesions with significant mass effect. Stereotactic biopsy and microbiological analysis identified Cladophialophora species as the causative organism. The patient was managed with surgical drainage and prolonged antifungal therapy using liposomal amphotericin B and voriconazole, resulting in significant clinical improvement. This case highlights the importance of considering fungal infections in patients with atypical brain lesions, even in the absence of overt immunosuppression. Early recognition combined medical–surgical management, and prolonged antifungal therapy are critical for improving outcomes.

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Cite

BibTeXRIS
BibTeX
@article{hamad2026primary,
  title = {{Primary cerebral pheohyphomycosis in an immunocompetent adult: A case report and review of the literature}},
  author = {Hani Hamad and Mohammed Abu Khattab and Husam Eldin Salah and Ali Omrani and Sreethish Sasi and Muna Al Maslamani},
  journal = {IDCases},
  year = {2026},
  month = oct,
  doi = {10.1016/j.idcr.2026.e02808},
  url = {https://doi.org/10.1016/j.idcr.2026.e02808},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Primary cerebral pheohyphomycosis in an immunocompetent adult: A case report and review of the literature
AU  - Hani Hamad
AU  - Mohammed Abu Khattab
AU  - Husam Eldin Salah
AU  - Ali Omrani
AU  - Sreethish Sasi
AU  - Muna Al Maslamani
PY  - 2026
DA  - 2026/10/22
JO  - IDCases
DO  - 10.1016/j.idcr.2026.e02808
UR  - https://doi.org/10.1016/j.idcr.2026.e02808
AB  - Cerebral pheohyphomycosis is a rare, life-threatening central nervous system infection caused by dematiaceous fungi. It predominantly affects immunocompromised individuals; however, cases in immunocompetent hosts have been increasingly reported, particularly in association with environmental exposure. The diagnosis is challenging due to nonspecific clinical manifestations and radiological features that often mimic neoplastic or bacterial lesions. We report the case of a previously healthy 45-year-old Kenyan male who presented with chronic headache and progressive neurological deficits. Neuroimaging revealed multiple intracranial lesions with significant mass effect. Stereotactic biopsy and microbiological analysis identified Cladophialophora species as the causative organism. The patient was managed with surgical drainage and prolonged antifungal therapy using liposomal amphotericin B and voriconazole, resulting in significant clinical improvement. This case highlights the importance of considering fungal infections in patients with atypical brain lesions, even in the absence of overt immunosuppression. Early recognition combined medical–surgical management, and prolonged antifungal therapy are critical for improving outcomes.
SN  - 2214-2509
ER  -