Pseudallescheria boydii Brain Abscess Successfully Treated with Voriconazole and Surgical Drainage: Case Report and Literature Review of Central Nervous

Pseudallescheria boydii and its asexual form, Scedosporium apiospermum, are ubiquitous, saprophytic fungi that commonly cause cutaneous infection. However, in certain circum-stances, P. boydii can also cause invasive disease, which can involve the central nervous system (CNS). When the CNS becomes involved, treatment is dif®cult, therapeutic options are lim-ited, and the prognosis is poor. We report a case of Pseudallescheria brain abscess successfully treated with surgical drainage and systemic voriconazole, the ®rst such case to be described in the literature. We also review previously reported cases of CNS pseudallescheriasis and evaluate therapeutic options. The fungi that most commonly cause CNS infections are Candida species and Cryptococcus neoformans [1±3]. However, with the increasing prevalence of immunosuppression (in pa-tients who have undergone organ transplantation, who are re-ceiving chemotherapy for neoplasm, who have AIDS, etc.), other opportunistic fungi have recently emerged as important pathogenic organisms [4±6]. Among these emerging agents, P