Year: 2021
Type: article
Study design: Case Report
Abstract: Cladophialophora species are fungi, which almost exclusively cause infections of the central nervous system. Mortality from Cladophialophora exceeds 65% despite treatment. Although it is a rare infection in the United States, the use of multiple and concurrent immunosuppressants has led to surges in invasive fungal infections. We present a case of cerebral phaeohyphomycosis caused by Cladophialophora bantiana in a patient with multiple sclerosis and rheumatoid arthritis, who was treated with fingolimod and methotrexate. The patient presented with altered mental status and aphasia secondary to a loculated abscess in the left temporal region. She underwent surgical debridement and was treated with antifungals. Fingolimod and methotrexate were discontinued indefinitely, and the patient recovered. Fingolimod, a lymphocyte-depleting agent, increases the risk of opportunistic infections, especially if used concurrently with other disease modifying therapies, therefore, careful selection of a single agent should be performed in patients with MS and other concurrent autoimmune disorders.
Source: Neuroimmunology Reports
Institution: Mayo Clinic in Florida
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,000
OpenAlex ID: W3206406676