The Centers for Disease Control and Prevention and researchers are warning of a sharp rise in infections from Cladophialophora bantiana, a rare and highly deadly brain-eating mold. Detections of the fungus at a key University of Washington laboratory increased fourfold from 2023 to 2025, rising to 14 cases in 2025. The infection, which carries a 60% to 70% mortality rate, is uniquely alarming because about half of the cases occur in otherwise healthy individuals. Public health officials are calling for national surveillance to address significant data gaps.
Diagnosis and treatment of brain abscesses
- ▪Cladophialophora bantiana infections typically present as brain abscesses and are associated with a case-fatality rate of 60% to 70% even with treatment.
- ▪For patients with Cladophialophora bantiana brain abscesses, researchers recommend surgical excision paired with combination antifungal therapy using liposomal amphotericin B, posaconazole or voriconazole, and flucytosine.
- ▪The Centers for Disease Control and Prevention advised clinicians to consider Cladophialophora bantiana in patients with signs and symptoms of a brain abscess.
Rise in detections at University of Washington laboratory
- ▪The University of Washington laboratory identified 48 confirmed and one probable Cladophialophora bantiana cases from January 2009 to July 2026, ranging annually from one to five (2009–2023) before rising to eight in 2024 and 14 in 2025.
- ▪The Cladophialophora bantiana detection rate at the University of Washington laboratory rose from an annual average of 8.4 cases per 1,000 central nervous system specimens in 2017–2023 to 26 cases per 1,000 specimens in 2025.
- ▪The frequency of Cladophialophora bantiana detections per 1,000 submitted central nervous system specimens at the University of Washington laboratory increased approximately fourfold from 2023 to 2025.
Geographic distribution of cases in the United States
- ▪The 49 confirmed and probable Cladophialophora bantiana cases identified between January 2009 and July 2026 were distributed across 21 United States states and Washington, D.C.
- ▪Among the identified Cladophialophora bantiana cases in the United States, California recorded six cases, followed by Florida and Texas with five cases each, and Pennsylvania with four cases.
Lack of national surveillance and calls for reporting
- ▪The Centers for Disease Control and Prevention and researchers called for systematic reporting and data collection from clinical laboratories to understand the true disease burden of Cladophialophora bantiana in the United States.
- ▪There is no routine national surveillance for Cladophialophora bantiana in the United States, and clinicians are not obligated to report suspected or confirmed cases to public health departments.
Debatable claims
- ▪The rise in Cladophialophora bantiana cases justifies public health alarm
- ▪Climate change is the primary driver of rising Cladophialophora bantiana infections
- ▪The US should mandate national reporting for Cladophialophora bantiana infections
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