Cerebral Chromoblastomycosis [Neurosurgery Wiki]

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====== Cerebral Chromoblastomycosis ======

====== Cerebral Chromoblastomycosis: A Unique Presentation of Dematiaceous Fungal Infection in an Immunocompromised Patient ======

In a case report – culture/histopathology confirmed.  
Norton Stephen et al.  
from AIIMS Madurai (Madurai), JIPMER Puducherry (Puducherry), Neurosurgery JIPMER Puducherry.  
published in [[Annals of Indian Academy of Neurology]].  
to report an unusual intracranial dematiaceous [[fungal infection]] (“cerebral chromoblastomycosis”) in an immunocompromised host.  
Demonstrates that dematiaceous fungi can invade the CNS in immunosuppressed patients, presenting as [[brain abscess]]es; underscoring need for high suspicion, tissue diagnosis, and tailored [[antifungal therapy]]
((Stephen N, Ravi S, Hanuman SB, Negi VS, Gopalakrishnan MS. Cerebral Chromoblastomycosis: A Unique [[Presentation]] of Dematiaceous [[Fungal Infection]] in an Immunocompromised Patient. Ann Indian Acad Neurol. 2025 Jul 7. doi: 10.4103/aian.aian_747_24. Epub ahead of print. PMID: 40622678.)).

==== Critical Review ====

1. **Novelty & Rigor:**  
   - Rare case: cerebral infection by pigmented dematiaceous fungus is exceedingly uncommon. Prior reports mostly in immunocompetent individuals :contentReference[oaicite:0]{index=0}.  
   - Methodology strong: pathology plus culture confirmation; however, imaging, antifungal regimen, and clinical course not detailed in provided abstract.

2. **Limitations:**  
   - Lack of comprehensive clinical data: dose/duration of therapy, immune status specifics (CD4, neutrophils), imaging, follow-up.  
   - Single-patient report: low evidence level, cannot generalize treatment outcomes or prognosis.

3. **Contextualization:**  
   - Builds on rare prior cases from India and abroad :contentReference[oaicite:1]{index=1}.  
   - Adds by highlighting immunocompromise as a risk—less emphasized previously.

4. **Take-home for neurosurgeon:**  
   - In immunocompromised patients with intracranial abscesses, include dematiaceous fungi in differential.  
   - Early biopsy/culture and combined medical–surgical management critical; delayed diagnosis likely worsens outcome.

5. **Verdict:**  
   - Despite lacking granularity, this well-documented rare case merits attention.  
   - Score: **6/10** (novelty strong, clinical details modest, limited generalizability).

==== Bottom Line for Practicing Neurosurgeon ====
Consider dematiaceous fungal abscesses (chromoblastomycosis/phaeohyphomycosis) in immunosuppressed patients with brain lesions; surgical biopsy and pathogen-directed antifungal therapy are essential.



==== Categories ====
neurosurgery_case_reports, fungal_neurosurgery, CNS_infections  

==== Tags ====
chromoblastomycosis, dematiaceous_fungi, brain_abscess, immunocompromised, case_report, invasive_mycosis