Cerebral phaeohyphomycosis caused by Cladosporium bantianum: a case in a female who had cutaneous alternariosis in her childhood.

A rare case is presented of mycotic infection in a Japanese female, who had cutaneous alternariosis in the face at age 9, and died of cerebral phacohyphomycosis 8 years later. To our knowledge, this is the first reported case in which these two unusual and different mycoses have occurred successively in the same person. The cerebral lesions were located in the right parietal region close to the sulcus centralis and in the region of the right cerebral lateral fissure. They were granulomatous and characterized by the presence of numerouse microabscesses. In the center of these were seen many dematiaceous fungal elements that consisted mainly of light brown, septate hyphae 1.5-2.5 micrometer in diameter, from which elongated cells 3-4 X 8-10 microgram in size were seen proliferating. In addition, yeast-like cells 8-10 microgram in diameter were observed. The etiologic agent isolated from the brain lesions was identified as Cladosporium bantianum (Sace.) Borelli (=Cladosporium trichnoides Emmons) on the basis of our morphological and physiological findings and its neurotropism in experimentally inoculated mice.