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A CDC report describes a rise in detections of Cladophialophora bantiana, a rare fungus that often causes brain abscesses and can be fatal. One U.S. reference laboratory recorded 14 cases in 2025, up from an annual range of one to five during 2009–2023; researchers say the increase’s cause and the true number of infections remain uncertain.
A CDC-published report describes a sharp rise in detections of Cladophialophora bantiana, a rare fungus that can cause brain abscesses, at a University of Washington reference laboratory. The lab recorded 14 cases in 2025, compared with one to five annually from 2009 through 2023; 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. The report, published in the CDC’s Morbidity and Mortality Weekly Report, also found that the case rate among central nervous system specimens increased from an annual average of 8.4 per 1,000 specimens in 2017–2023 to 26 per 1,000 in 2025.
Of the 49 confirmed and probable cases, 88% were detected in tissue from the brain or other intracranial central nervous system sites, while 12% were detected in lung specimens. The median patient age was 68. Cases were identified in samples from 21 states and the District of Columbia; California reported six, Florida and Texas five each, and Pennsylvania four.
The report says C. bantiana infections commonly affect the central nervous system and present as brain abscesses. The infection is associated with a case-fatality rate of up to 70%, according to the source report. That figure describes reported case fatality and does not establish an individual patient’s prognosis.
Why Brain Abscess Cases Matter
The increase matters because the infection is rare, difficult to detect and potentially severe. Researchers said cases have occurred in people who appear to have healthy immune systems as well as in people who are immunosuppressed. That may make the fungus harder to suspect when a patient’s risk factors do not fit the usual pattern for serious fungal disease.
For clinicians, the report points to C. bantiana as a possible cause when a brain abscess remains unexplained after routine cultures or testing. The researchers said laboratory diagnosis can be challenging because molds may not grow readily in culture, raising the possibility that reported detections do not capture every infection. The findings do not establish that infections are increasing nationwide at the same rate as detections at this laboratory.
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How the Laboratory Counts Changed
The University of Washington clinical reference laboratory tests samples from across the United States. Its data show a long period of one to five annual detections from 2009 through 2023, followed by eight in 2024 and 14 in 2025. The report’s case-rate comparison uses central nervous system specimens as its denominator, rather than the U.S. population.
The researchers described inhalation or direct inoculation after a skin injury as presumed routes of infection. The presence of lung specimens is consistent with a possible respiratory route, but the report does not establish how each patient became infected. The cases were spread across multiple states, and the laboratory data alone cannot show where exposure occurred.
“C. bantiana is a rare but important cause of brain abscess in both healthy and immunosuppressed people.”
— Joshua Lieberman, a University of Washington School of Medicine researcher, speaking to MedPage Today
What Is Driving the Increase
The data come from a single specialized laboratory, so they do not by themselves establish a nationwide rise in the underlying incidence of infection. Researchers said higher specimen submissions or improved molecular testing could account for some of the increase. They also raised environmental change, including warming, and human encroachment on the fungus’s environmental reservoir as possible explanations, but the report does not demonstrate that either caused the trend.
The true incidence remains unknown, as does the extent of undercounting. At least one other specialized U.S. fungal laboratory has reportedly observed more detections, according to Lieberman, but the source material does not provide comparable counts or methods. It is also unclear why the fungus primarily affects the brain or where individual patients were exposed.
Monitoring Cases and Diagnosis
The report does not announce a new CDC testing program or a specific follow-up deadline. Researchers’ next steps include interpreting the trend as more data become available and determining whether increased detections reflect changes in infection rates, testing or both. The source material does not specify a planned national surveillance effort.
In the meantime, Lieberman said clinicians may consider rare causes such as C. bantiana when a brain abscess cannot be diagnosed through routine culture or cerebrospinal fluid testing, particularly in someone who otherwise appears healthy. The source report discusses surgical removal of abscesses alongside combination antifungal treatment; treatment decisions must be made by qualified clinicians based on the individual case.
Key Questions
What is Cladophialophora bantiana?
C. bantiana is a rare mold associated with serious infections that commonly affect the central nervous system and may present as brain abscesses.
How many cases did the laboratory detect?
The University of Washington reference laboratory identified 48 confirmed and one probable case from January 2009 through July 2026. It recorded 14 cases in 2025.
Does the report prove infections are increasing across the country?
No. It documents increased detections at one laboratory. Researchers said more submitted samples or improved testing could explain part of the rise, and the national incidence is not known.
Can people with healthy immune systems get the infection?
Yes. The report and researcher comments describe cases in people who appeared to have healthy immune systems as well as in immunosuppressed people. The findings do not estimate an individual’s risk.
How does the fungus spread?
The researchers describe inhalation or direct inoculation after a skin injury as presumed routes. The route of infection has not been established for every case.
Source: rss
