Brain Abscess Caused by Cladosporium trichoides

The term "cladosporiosis" has been used to describe the rare clinical syndrome of cerebral infection caused by the dematiaceous (ie, pigmented olivaceous-brown) fungusCladosporium trichoides. Usually, infection ends in death within one year of diagnosis. In spite of empirical attempts with a variety of antimicrobial agents, no successful chemotherapy is known. Furthermore, although there have been some apparent surgical successes, extirpation has been confounded often by multiple abscesses or by recurrence of disease at the site of a single abscess. Recently, however, Block et al¹have reported laboratory data that suggested that flucytosine was active againstCladosporium trichoides. We report two patients with cladosporiosis who are, to our knowledge, the sixth and seventh patients from the United States, the 18th and 19th in the world, and the first to receive flucytosine. PATIENT SUMMARIES Patient 1.— A 63-year-old laborer, who had not travelled outside of the state of Virginia, was