Disseminated neuroinfection caused by Rhinocladiella mackenziei in a patient with Systemic Lupus Erythematosus: Case report and review of literature
Nawal Al-Kindi1, Humaid A. Al Wahshi2, Zainab Kallow2, Alia Al-Hajri3, Ibrahim Al-Busaidi4, Faryal Khamis5, Habib. Al-Jahdhami6, Hein van der Lee7, Fatima Zohra Delma7, Saif Al-Housni8, Suad Nasser Al-Saqri8, G. Sybren de Hoog7, Ahmed Al-Rawahi8, Ahmed Al-Harrasi8, Abdullah M.S. Al-Hatmi7,8#
1Khoula Hospital, Medical Microbiology Department, Muscat Oman; 2Royal Hospital, Rheumatology, Department of Medicine, Muscat, Oman; 3Royal Hospital, Radiology Department, Muscat, Oman; 4Sultan Qaboos University Hospital, Department of Medicine, Infectious Diseases Unit, Muscat, Oman; 5Royal Hospital, Adult Infectious Diseases, Department of Medicine, Muscat, Oman; 6Sultan Qaboos University, College of Medicine, Department of Biomedical Science, Muscat, Oman; 7Center of Expertise for Mycology, Radboud University Medical Center/Canisius Wilhelmina Hospital, Nijmegen, The Netherlands; 8Natural & Medical Sciences Research Centre, University of Nizwa, Nizwa, Oman
Abstract
Rhinocladiella mackenziei is a dematiaceous fungus that has been reported as the cause of fatal cases of brain abscess exclusively in the Middle East. Although it is rare, the mortality rate in both immunocompetent and immunocompromised individuals is 100%. We report a case of R. mackenziei brain abscess in a young immunocompromised patient. Despite receiving a combined antifungal therapy that included the newer triazole isavuconazole intravenously, as well as liposomal amphotericin B, voriconazole, and terbinafine the patient died. We examine the literature on the relationship between SLE in immunocompetent patients and brain infections caused by R. mackenziei. According to available information, SLE and other autoimmune illnesses may increase the risk of developing a fungal infection
Open Access
Cite this article :
Al-Kindi N, Al Wahshi HA, Kallow Z, Al-Hajri A, Al-Busaid A, Khamis F, Al-Jahdhami H, van der Lee H, Delma FZ, Al-Housni S, Nasser Al-Saqri S, de Hoog GS, Al-Rawahi A, Al-Harrasi A, Al-Hatmi AMS 2024 Disseminated neuroinfection caused by Rhinocladiella mackenziei in a patient with Systemic Lupus Erythematosus: Case report and review of literature. One Health Mycology 1(2), 47-53
ISSN: 3050-4627
doi.org/10.63049/OHM.24.12.1
Keywords: Rhinocladiella mackenziei, brain, systemic lupus erythematosus, SLE, Middle East
Article highlights:
- A brain infection by Rhinocladiella mackenziei is described.
- Nearly all 41 cases reported to date occurred in patients in or originating from the Middle East.
- Cases also occur in immunocompetent patients and are almost 100% fatal despite medical intervention.
#Correspondence: a.alhatmi@unizwa.edu.om
Article info:
Received 1 September 2024
Revised 15 September 2024
Accepted 16 September 2024
Appeared online 25 September 2024
One Health Mycology 1(2): 47−53, 2024