Cerebral Phaeohyphomycosis: A Rare Case from South India

Background and Importance Cerebral phaeohyphomycosis is a rare but frequently fatal clinical entity caused by dematiaceous fungi like Cladophialophora bantiana. Clinical signs and symptoms related to fungal brain abscess can be subtle, and its imaging appearance may be indistinguishable from those of other intracranial mass lesions. Still, recognition of typical imaging patterns on CT and MRI helps to refine the differential diagnosis and initiate early treatment of these infections. Case presentation Ours is a case of a 48 year old immunocompetent male presented with right sided hemiparesis and hemisensory loss and a provisional diagnosis of stroke was made. Radiological evaluation suggested the possibility of a cerebral abscess. Accordingly surgical excision of the lesion was performed and the histopathological examination of the specimen revealed the etiology as phaeohyphomycosis. The patient was further treated with antifungals and discharged when general conditions improved. Conclusion Fungal CNS infections present diagnostic challenges and should be considered while interpreting ring enhancing CNS lesions in immuno‑competent patients. Surgical resection and antifungal treatment should be considered in all the patients of cerebral phaeohyphomycosis.