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John F. Fisher, MD; Smith Shadomy, PhD; J. Robert Teabeaut, MD; Janet Woodward, MS; Gene E. Michaels, PhD; Mark A. Newman, PhD; Elizabeth White, MS; Paul Cook; Annette Seagraves; Farivar Yaghmai, MD; J. Peter Rissing, MD

Arch Neurol. 1982;39(8):511-513.

Abstract
• Extracutaneous infection from Petriellidium boydii is an unusual occurrence despite the ubiquity of the organism in nature. Central nervous system infection by this organism is extremely rare, only seven previous reports having been found. The rarity of this manifestation prompted the report of a brain abscess occurring in a previously healthy youth after a near-drowning. The source of the infection was likely to have been the river water at the accident site, from which P boydii was isolated. Although previous in vitro susceptibility data and failure of amphotericin B therapy in a similar infection suggested miconazole treatment might be beneficial, the organism causing the brain abscess was resistant to miconazole and amphotericin B. This report emphasizes the urgent need for safer and more predictably effective alternatives to currently available antifungal agents.

Author Affiliations
From the Infectious Disease Section, Medical College of Georgia, Augusta (Drs Fisher, Teabeaut, Yaghmai, and Rissing, Mr. Cook, and Ms Seagraves); the Division of Infectious Diseases, Medical College of Virginia, Richmond (Dr Shadomy); the Department of Microbiology, University of Georgia, Athens (Dr Michaels and Mss Woodward and White); and the Centers for Disease Control, Atlanta (Dr Newman).

Footnotes
Accepted for publication Nov 2, 1981.

Reprint requests to Infectious Disease Section, Medical College of Georgia, Augusta, GA 30912 (Dr Fisher).

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