### Microbiology A fungus. *Rhinocladiella* *aquaspersa*, *R* *similis*, *R *mackenziei*. *R*. atrovirens, *R*. *basitona*. ### Epidemiologic Risks Found in tropical soil, inoculated into the feet of them what can't afford shoes. *Rhinocladiella* *mackenziei* is found in the mid-East. ### Syndromes *Rhinocladiella* *aquaspersa*, *Rhinocladiella* *similis*: Chromomycosis. *Rhinocladiella* *mackenziei* brain abscess/phaeohyphomycos in poor hosts. ### Treatment *Rhinocladiella* *mackenziei*: I&D if possible. NOT amphotericin, perhaps the azoles posaconazole or isavuconazole. [^1] Evidently it is > "nearly 100% (fatal) with no instances of documented survival of patients." [^2] Which doesn't sound like 'nearly' to me. *Rhinocladiella* *aquaspersa*, *Rhinocladiella* *similis*: posaconazole, itraconazole , voriconazole. [^3] ### Notes *Rhinocladiella* *mackenziei* is a biohazard for the lab. ### Rationalizations [^1]: Kauser Jabeen, Joveria Farooqi, Afia Zafar, Bushra Jamil, Syed Faisal Mahmood, Farheen Ali, Noureen Saeed, Abrar Barakzai, Arsalan Ahmed, Erum Khan, Mary E. Brandt, Rumina Hasan, _Rhinocladiella mackenziei_ as an Emerging Cause of Cerebral Phaeohyphomycosis in Pakistan: A Case Series, _Clinical Infectious Diseases_, Volume 52, Issue 2, 15 January 2011, Pages 213–217, [https://doi.org/10.1093/cid/ciq114](https://doi.org/10.1093/cid/ciq114) [^2]: https://en.wikipedia.org/wiki/Rhinocladiella_mackenziei [^3]: González GM, Rojas OC, González JG, Kang Y, de Hoog GS. Chromoblastomycosis caused by Rhinocladiella aquaspersa. Med Mycol Case Rep. 2013 Aug 31;2:148-51. doi: 10.1016/j.mmcr.2013.08.001. PMID: 24432242; PMCID: PMC3885939.