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A CDC-published report describes a rise in detections of Cladophialophora bantiana, a rare fungus that often causes brain abscesses. A University of Washington laboratory recorded 14 cases in 2025, up from an annual range of one to five in 2009–2023; researchers say the reasons and the true incidence remain unclear.
A CDC-published report describes a rise in detections of the rare fungus Cladophialophora bantiana at a University of Washington reference laboratory, including 14 cases in 2025, compared with one to five annually from 2009 through 2023. The fungus can cause brain abscesses and has been associated with case-fatality rates of up to 70%, but researchers say it is not yet clear whether the increase reflects more infections, improved detection, or other factors.
The laboratory identified 48 confirmed cases and one probable case from January 2009 through July 2026. Annual detections rose to eight in 2024 and 14 in 2025. Researchers reported the findings in the CDC’s Morbidity and Mortality Weekly Report; they describe laboratory detections, not a complete count of infections across the country.
Most detected infections involved the brain or central nervous system: 88% of the cases were found in intracranial CNS tissue specimens, while 12% were found in lung specimens. The researchers said this pattern is consistent with a presumed respiratory route of infection, although they also describe direct inoculation after a skin injury as another possible route. The case rate in CNS specimens increased from an annual average of 8.4 per 1,000 specimens in 2017–2023 to 26 per 1,000 in 2025.
The 49 confirmed and probable patients had a median age of 68. Samples came from 21 states and the District of Columbia, with cases spread across the country. California had six detections; Florida and Texas had five each, and Pennsylvania had four. These figures reflect cases identified by the laboratory and do not establish state-level infection rates.
The Risk of Fungal Brain Abscesses
The rise merits attention because C. bantiana can cause severe brain infections, including abscesses, and has been reported in people with and without known immune suppression. The cited case-fatality rate of up to 70% signals the potential seriousness of infection, but it is not a forecast of risk for the general public or a rate calculated from this laboratory’s 49 cases.
For clinicians, the report raises awareness of a rare possible cause when a brain abscess has not been explained by routine cultures or testing. For the public, the available data do not establish how likely infection is, whether risk has risen nationally, or whether any particular group or place is at greater risk.
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How Researchers Counted Cases
The findings come from a clinical reference laboratory at the University of Washington that tests samples submitted from across the United States. The report covers detections from January 2009 through July 2026, with the clearest annual increase occurring in 2024 and 2025. A separate comparison of CNS specimen results shows higher detections per 1,000 specimens in 2025 than the average for 2017–2023.
Laboratory surveillance is not the same as a national population-based count. The researchers said mold infections can be difficult to grow in culture and may be missed, while the number of specimens sent for testing and use of molecular testing may affect how many cases are found. At least one other specialized fungal laboratory has also seen a rise in detections, according to Joshua Lieberman, the report’s lead researcher, but the source material provides no combined national count.
“C. bantiana is a rare but important cause of brain abscess in both healthy and immunosuppressed people.”
— Joshua Lieberman, MD, PhD, University of Washington School of Medicine, speaking to MedPage Today
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What the Detection Rise Shows
The increase in laboratory detections does not by itself establish that infections have become more common across the United States. Researchers said the change could reflect more specimens being submitted or better detection through molecular testing; they also raised environmental changes, including a warming climate and human contact with the fungus’s environmental reservoir, as possible explanations. Those factors are possibilities, not established causes of the observed increase.
The true incidence is unknown, and the laboratory data do not establish a population-based risk, why the fungus tends to affect the brain, or the source of individual infections. The reported fatality figure is an estimate described in the source material, not an outcome rate calculated from this case series. The available account also does not provide detailed outcomes for all 49 patients.
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Clinical Awareness and Further Tracking
The report’s findings may prompt clinicians to consider rare fungal causes when a brain abscess remains unexplained after routine culture or cerebrospinal fluid testing, particularly in a patient without an obvious immune-system risk. Lieberman suggested that such cases warrant consideration of organisms including C. bantiana; the report does not advise testing every patient with a brain abscess for this fungus.
The source account says treatment for identified infections may involve surgical removal of the abscess alongside combination antifungal therapy, including medicines such as liposomal amphotericin B, posaconazole or voriconazole, and flucytosine. Treatment decisions are clinical and depend on the individual case. Further surveillance and research will be needed to determine whether detections continue to rise and to distinguish changes in infection from changes in testing and reporting.
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Key Questions
What is Cladophialophora bantiana?
C. bantiana is a rare fungus that can infect the central nervous system and cause a brain abscess. The report describes infections in both apparently healthy and immunosuppressed people.
How many cases did the laboratory identify?
The University of Washington reference laboratory identified 48 confirmed and one probable case from January 2009 through July 2026. This is a laboratory case count, not a complete national tally.
Why did detections increase?
The reason is unknown. Researchers said more submitted samples or improved molecular testing could explain some of the rise; they also raised environmental changes as possibilities, without establishing a cause.
Does the report show that the fungus is spreading across the country?
Cases were detected in samples from 21 states and the District of Columbia, but the report does not establish a national increase in infection rates. The laboratory’s data are not a population-based survey.
What should clinicians know about diagnosis and treatment?
The researchers suggested considering rare causes such as C. bantiana when a brain abscess remains undiagnosed through routine testing. The source describes surgery and combination antifungal therapy for diagnosed infections; care decisions should be made by qualified clinicians.
Source: rss
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