Transplant Recipient Due to Cladophialophora bantiana†

We describe a necrotizing cerebritis in an allogeneic bone marrow transplant recipient caused by the neurotropic, dematiaceous fungus Cladophialophora bantiana. The patient presented 7 months after bone marrow transplantation with fever and sudden onset of left-sided weakness, followed shortly by cranial nerve III and VI palsies. The patient had a lesion (3.0 by 2.0 by 2.0 cm) of the right midbrain with extension to the pons, the left brain stem, and the right superior and the middle cerebellar peduncles. The diagnosis was made by microscopic examination and culture of a brain biopsy. Dematiaceous fungi causing central nervous system (CNS) phaeohyphomycosis in humans include Wangiella dermatitidis, Fonsecaea pedrosoi, Dactylaria constricta var. gallopava, Bipo-laris spicifera, Curvularia pallescens, and Cladophialophora ban-tiana (5). C. bantiana, previously known as Torula bantiana