Phaeohyphomycosis in a COVID-19 Patient Caused by Neoscytalidium Dimidiatum

Abstract We report a case of 32-years-old male with a cerebral phaeohyphomycosis post COVID-19 infection from Iran. The causative agent was identified by histopathology, routine mycological methods and confirmed by DNA sequencing of the internal transcribed spacer (ITS) region of rDNA and proved to be Neoscytalidium dimidiatum which is an opportunistic dematiaceous fungus belonging to Dothideomycetes.No apparent underlying disease was seen beside his COVID-19 complications and corticosteroid therapy. Symptoms indicative of his fungal infection appeared two weeks after his COVID-19 scenario. The brain MRI showed multi-focal CNS infection as abscess. Delayed identification of the fungus and antifungal treatment with amphotericin B may have affected the outcome, thus the patient died on day 25 post COVID-19 infection.Considering, rare incidence of infections due to N. dimidiatum, reporting this case will add to our awareness and may lead us to a timely management.