Cladophialophora

Cladophialophora is a genus of dematiaceous, or pigmented, fungi in the family Herpotrichiellaceae. Members of this genus are primarily environmental, commonly found in soil, decaying vegetation, and plant debris, but several species can act as opportunistic pathogens in humans.

Morphologically, Cladophialophora species are characterized by septate, darkly pigmented hyphae and the production of conidia in chains on conidiophores. The conidia are typically formed in uniseriate chains, giving the genus a distinctive chain-like sporulation pattern under appropriate culture conditions. Many species grow slowly and produce colonies with a dark pigment.

Ecology and distribution are worldwide, with higher detection in tropical and subtropical regions where environmental exposure is common. While most species are nonpathogenic, some can cause disease in humans, ranging from subcutaneous infections to serious disseminated disease, particularly in individuals with compromised or, in some cases, even normal immune function.

Clinical significance is highlighted by two well-known species. Cladophialophora bantiana is neurotropic and associated with brain abscesses and cerebral phaeohyphomycosis; these infections can be severe and require aggressive treatment. Cladophialophora carrionii is a recognized cause of chromoblastomycosis, a chronic cutaneous and subcutaneous infection characterized by verrucous lesions and, in tissue, the presence of muriform “copper penny” cells. Other Cladophialophora species have been reported in sporadic cutaneous or sinus infections.

Diagnosis relies on culture and histopathology, with molecular methods (such as ITS and LSU sequencing) aiding species identification. Treatment generally involves systemic antifungal therapy (for example itraconazole or voriconazole) and, when feasible, surgical excision of localized lesions; central nervous system involvement often carries a poorer prognosis.