It is caused by certain species of fungi belonging to the group known as dematiaceous fungi, which are characterized by the presence of dark pigmented hyphae (the branching filaments of fungi).
Phaeohyphomycosis is a term used to define infections caused by darkly pigmented fungi with septate hyphae which contain melanin in their cell walls. Although fungi rarely cause central nervous system (CNS) infections, the incidence of CNS infections caused by melanin-containing fungi has been increasing in the recent years.
This type of infection typically occurs in individuals with weakened immune systems, such as those with HIV/AIDS, undergoing immunosuppressive therapy, or having other underlying conditions that compromise the immune system. However, cases have been reported in immunocompetent individuals as well.
Treatment typically involves a combination of antifungal medications such as voriconazole, posaconazole, or amphotericin B, along with surgical intervention to remove infected tissue if feasible. Prognosis can vary depending on the extent of the infection, the immune status of the patient, and the timeliness of treatment.
Due to its rarity and potentially serious consequences, cerebellar phaeohyphomycosis requires prompt recognition and management by a multidisciplinary medical team, often including infectious disease specialists, neurosurgeons, and critical care physicians 1).