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A CDC report describes a rise in detected cases of Cladophialophora bantiana, a rare fungus that commonly causes brain abscesses and can be fatal. A University of Washington reference laboratory identified 14 cases in 2025, up from an annual range of one to five during 2009–2023; researchers say the reasons are unknown and the figures may underestimate infections.
A CDC report describes a recent rise in detections of Cladophialophora bantiana, a rare fungal infection that most often affects the brain and can cause brain abscesses. A University of Washington clinical reference laboratory recorded 14 cases in 2025, compared with one to five cases annually from 2009 through 2023; researchers say the reason for the increase is not known.
The laboratory identified 48 confirmed cases and one probable case from January 2009 through July 2026. Its annual count rose to eight in 2024 and 14 in 2025. The report, published by the Centers for Disease Control and Prevention in its Morbidity and Mortality Weekly Report, describes detections from samples sent to the specialized laboratory, not a complete count of infections across the country.
Most infections involved the central nervous system: 88% of the cases were detected in intracranial tissue specimens, while 12% were found in lung specimens. The researchers said the pattern is consistent with a presumed respiratory route of infection, though they also describe direct inoculation after a skin injury as a possible route. The cases were detected in samples from 21 states and the District of Columbia. California had six, Florida and Texas five each, and Pennsylvania four.
The patients had a median age of 68 years. Researchers say the infection can affect both immunosuppressed people and people who appear to have healthy immune systems. The report cites case-fatality rates of up to 70%; that figure describes the reported potential severity and is not a prediction for any individual patient.
A Rare Infection With Severe Outcomes
The rise matters because C. bantiana can cause severe brain infection, and clinicians may not identify it through routine testing. The fungus is an uncommon cause of brain abscess, but researchers say it should be considered when a brain abscess remains undiagnosed, particularly in someone without an obvious immune-system risk factor.
The findings do not establish that infections are increasing across the whole U.S. population. They do show that a specialized laboratory detected more cases in recent years, and another U.S. fungal laboratory has also seen an increase, according to Joshua Lieberman, the report’s lead researcher. The numbers may inform clinical awareness, but they cannot by themselves establish how often the infection occurs or what is driving the pattern.
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How the Laboratory Counts Changed
The University of Washington laboratory’s annual detections ranged from one to five cases between 2009 and 2023, then increased to eight in 2024 and 14 in 2025. The report also compared detection rates in central nervous system specimens: an average of 8.4 cases per 1,000 specimens annually during 2017–2023, versus 26 per 1,000 in 2025. These are laboratory detection rates, not population-wide infection rates.
The fungus is difficult to grow in laboratory cultures, researchers said, and the reported total may miss infections. More submitted samples or improved molecular testing could also account for some of the increase. Lieberman raised warmer environmental conditions and human encroachment into the fungus’s environmental reservoir as possible explanations, but the report does not establish either as the cause.
“C. bantiana is a rare but important cause of brain abscess in both healthy and immunosuppressed people.”
— Joshua Lieberman, University of Washington School of Medicine
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Why Detections Have Increased
The cause of the rise remains unclear. Researchers said greater sample submissions and improved molecular testing could explain some of the change. They also raised climate-related factors and increased human contact with environmental sources as possibilities, not confirmed causes.
The laboratory’s figures do not measure every U.S. infection, and the true incidence is unknown. The report also cannot establish whether the rise reflects a broader increase in infections, changes in testing and referral patterns, or a combination of factors. The specific source of infection for individual patients is not established by the reported counts.
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More Surveillance and Clinical Detection
Researchers and public health officials will need further surveillance to determine whether detections continue to rise and whether the pattern appears in more laboratories and patient populations. The report does not announce a new national case-counting system or a confirmed cause for the increase.
Lieberman said clinicians facing a brain abscess that routine culture or cerebrospinal fluid testing has not explained may need to consider rare causes such as C. bantiana. The report discusses treatment approaches involving surgical removal of the abscess alongside combination antifungal therapy; decisions about diagnosis and treatment belong with qualified clinicians.
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Key Questions
What is Cladophialophora bantiana?
C. bantiana is a rare fungus that commonly affects the central nervous system and can cause brain abscesses. The CDC report describes infections detected in brain-related tissue and lung specimens.
How many cases did the laboratory find?
The University of Washington reference laboratory identified 48 confirmed and one probable case between January 2009 and July 2026. These are laboratory detections, not a complete national count.
Why did case detections rise?
The reason is unknown. Researchers said increased sample submissions and improved testing may explain part of the rise. Environmental warming and human contact with the fungus’s reservoir were also raised as possibilities, not established causes.
Does the report show that infections are rising nationwide?
Not conclusively. It documents a rise at a specialized laboratory and reports that another U.S. fungal laboratory also saw more detections. The true incidence and the extent of any nationwide increase remain unclear.
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