Ramichloridium mackenziei brain abscess: report of two cases and review ofthe literature

We report two cases of brain abscesses caused by Ramichloridium mackenziei, a neurotropic dematiaceous fungus that seems to be geographically restrict ed to the Middle East. One of the patients had chronic myelomonocytic leuke mia but did not receive any chemotherapeutic agents. The other patient was a normal host. Both cases had a fatal outcome despite aggressive antifungal therapy and surgical intervention. Herein, we review all previously descri bed cases in the literature, and discuss the epidemiology, mycology and his topathology of this life-threatening organism.