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Utility of liquid biopsy in diagnosing isolated cerebral phaeohyphomycosis: illustrative case.
- Source :
-
Journal of neurosurgery. Case lessons [J Neurosurg Case Lessons] 2022 Jan 31; Vol. 3 (5). Date of Electronic Publication: 2022 Jan 31 (Print Publication: 2022). - Publication Year :
- 2022
-
Abstract
- Background: Cladophialophora bantiana is a dematiaceous, saprophytic fungus and a rare but reported cause of intracranial abscesses due to its strong neurotropism. Although it predominantly affects immunocompetent individuals with environmental exposure, more recently, its significance as a highly lethal opportunistic infection in transplant recipients has been recognized. Successful treatment requires timely but often challenging diagnosis, followed by complete surgical excision. Next-generation sequencing of microbial cell-free DNA (cfDNA) from plasma is a novel diagnostic method with the potential to identify invasive fungal infections more rapidly and less invasively than conventional microbiological testing, including brain biopsy.<br />Observations: The authors described the case of a recipient of a liver transplant who presented with seizures and was found to have innumerable ring-enhancing intracranial lesions. The Karius Test, a commercially available method of next-generation sequencing of cfDNA, was used to determine the causative organism. Samples from the patient's plasma identified C. bantiana 6 days before culture results of the surgical specimen, allowing optimization of the empirical antifungal regimen, which led to a reduction in the size of the abscesses.<br />Lessons: The authors' findings suggest that microbial cfDNA sequencing may be particularly impactful in improving the management of brain abscesses in which the differential diagnosis is wide because of immunosuppression.
Details
- Language :
- English
- ISSN :
- 2694-1902
- Volume :
- 3
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Journal of neurosurgery. Case lessons
- Publication Type :
- Academic Journal
- Accession number :
- 36130566
- Full Text :
- https://doi.org/10.3171/CASE21557