Case Report: Successful Treatment of Cerebral Phaeohyphomycosis with Voriconazole: A Case Report and Literature Review

Hao Bai Department of Pharmacy, Chongqing University Cancer Hospital, Chongqing, China;

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Chao Li Department of Pharmacy, Chongqing University Cancer Hospital, Chongqing, China;

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Xiangyu Lai Department of Pharmacy, Chongqing University Cancer Hospital, Chongqing, China;

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Xiaogang Hu Department of Pharmacy, Chongqing University Cancer Hospital, Chongqing, China;

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Lixian Li Department of Pharmacy, Chongqing University Cancer Hospital, Chongqing, China;

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Wanyi Chen Department of Pharmacy, Chongqing University Cancer Hospital, Chongqing, China;
College of Bioengineering, Chongqing University, Chongqing, China

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ABSTRACT.

Fonsecaea monophora is a species of Fonsecaea that belongs to Chaetothyriales. It is usually isolated from tropical and subtropical regions, causing reactive inflammation, skin abscesses, and pain. Cerebral infection caused by F. monophora is rare but often fatal. Diagnosing this disease at an early stage is difficult, and appropriate antifungal therapy is often delayed as a result. We report the case of a 53-year-old woman with type 2 diabetes who presented with a headache 2 months ago and progressive right-sided weakness of 1 month’s duration. Magnetic resonance imaging revealed a space-occupying lesion in the left frontal lobe and corpus callosum. The cystic mass was removed by surgical intervention, and the identification of the sample based on sequencing of the internal transcribed spaced region in BLAST-N search showed that the sequences producing most significant alignments were F. monophora or similar (query cover 99%, E value 0.0, per ident 99.84). The patient was treated with a 3-month course of twice daily voriconazole, leading to complete recovery.

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Author Notes

Financial support: This work was supported by the Chongqing Science and Health Joint Medical Research Project (Grant Number: 2021MSXM171), the Wu Jieping Medical Foundation (Grant Number: 320.6750.2022-20-25), and the Chongqing Key Specialty Construction Project of Clinical Pharmacy.

Disclosure: Our institution does not require ethical approval for reporting individual cases or case series.

Authors’ addresses: Hao Bai, Chao Li, Xiangyu Lai, Xiaogang Hu, and Lixian Li, Department of Pharmacy, Chongqing University Cancer Hospital, Chongqing, China, E-mails: 474027594@qq.com, lichaolucy@sina.com, 510327039@qq.com, hxgcq1987@126.com, and lilixian2010@yahoo.com. Wanyi Chen, Department of Pharmacy, Chongqing University Cancer Hospital, Chongqing, China, and College of Bioengineering, Chongqing University, Chongqing, China, E-mail: 32003371@qq.com.

Address correspondence to Wanyi Chen, Department of Pharmacy, Chongqing University Cancer Hospital, Hanyu Rd. No.181, Shapingba District, Chongqing 400030, China. E-mail: 32003371@qq.com
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