Background

Neoscytalidium dimidiatum is an opportunistic dematiaceous fungus belonging to the class Dothideomycetes.

Case report

We report a case of N. dimidiatum cerebral phaeohyphomycosis post COVID-19 infection in a 32-year-old male from Iran. The causative agent was identified by cytopathology, routine mycological methods, and DNA sequencing of the internal transcribed spacer (ITS) region of rDNA. Apart from COVID-19 complications and the corticosteroid therapy, no underlying condition was diagnosed. The symptoms suggesting the fungal infection were shown two weeks after being discharged from COVID-19 hospital stay. Magnetic resonance of the brain showed a multi-focal central nervous system infection. The delayed identification of the fungus and, thus, a late starting of the antifungal treatment with amphotericin B, might have affected the patient outcome as he finally died.

Conclusions

Considering the rare incidence of N. dimidiatum infections, this case should aware us about them, leading to a timely antifungal management.

中文翻译：

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COVID-19 患者由 Neoscytalidium dimidiatum 引起的暗色丝孢菌病

背景

Neoscytalidium dimidiatum是一种机会性暗色真菌，属于 Dothideomycetes 类。

案例报告

我们报告了一名来自伊朗的 32 岁男性感染 COVID-19 后感染N. dimidiatum脑暗色丝孢菌病的病例。通过细胞病理学、常规真菌学方法和 rDNA 内部转录间隔 (ITS) 区域的 DNA 测序确定了致病因子。除了 COVID-19 并发症和皮质类固醇治疗外，未诊断出任何潜在疾病。从 COVID-19 住院出院两周后，出现了表明真菌感染的症状。脑磁共振显示多灶性中枢神经系统感染。真菌的鉴定延迟，因此两性霉素 B 抗真菌治疗的开始时间较晚，可能会影响患者的预后，因为他最终死了。

结论

考虑到N. dimidiatum感染的罕见发生率，这个病例应该让我们了解它们，从而及时进行抗真菌治疗。