Detections of a Deadly Brain-Infecting Mold Rose About Fourfold at a U.S. Reference Lab From 2023 to 2025

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The numbers are still small, but the infection is serious. The report describes the fungus as a highly virulent mold that targets the nervous system and notes a 60% to 70% case-fatality rate even with aggressive therapy. About half of patients with this infection have no prior condition that weakens the immune system.

The data come from a clinical reference laboratory at the University of Washington that runs broad fungal DNA testing on specimens sent from across the country. From January 2009 through July 2026, the lab identified 49 cases: 48 confirmed and one probable. From 2009 through 2023, it found one to five cases a year. That rose to eight in 2024 and 14 in 2025.

The rate also climbed after accounting for testing volume, which helps separate a real increase from simply more testing. Detections averaged 8.4 per 1,000 brain and spinal cord specimens tested from 2017 to 2023, then reached 26 per 1,000 in 2025. The authors said the increase was not explained by a rise in laboratory referrals alone.

Patients came from 21 states and Washington, D.C., according to a CDC supplementary map of cases by state. California had six cases, Florida and Texas had five each, and Pennsylvania had four. Three cases had no state of origin recorded. The median patient age was 68.

“Reasons for the apparent increase are unknown,” the MMWR authors wrote. Joshua Lieberman, an associate professor of laboratory medicine and pathology at the University of Washington and an author of the report, told Gizmodo that the team tried to rule out increased testing as the explanation.

“Even though we tested more samples from the central nervous system over time, the number of C. bantiana cases increased faster,” Lieberman said. “So we think the increase is real.”

He was also careful about scale. “Although we think cases are still rare, we don’t have a clear picture of the disease burden right now,” he said, adding that the mold “is capable of infecting apparently healthy people, not just immunocompromised patients.”

The data have limits. All cases were tested at a single laboratory, and because of the nature of reference testing, little demographic, occupational, or clinical information was available, including outcomes for most patients. The lab also changed its DNA extraction method in February 2021. “National surveillance does not exist,” the authors wrote, as CIDRAP noted in its summary of the report.

How people become infected is not fully understood. The presumed route is breathing in the fungus or having it enter through a skin injury, after which it travels through the bloodstream to the brain. Six of the 49 detections, or 12%, came from lung samples, which the authors said supports the presumed respiratory route. Lieberman told Gizmodo that researchers do not know enough about where the mold occurs naturally.

The report does not list symptoms specific to this mold. Instead, it says doctors should consider the infection in patients with signs and symptoms of a brain abscess. MedlinePlus lists brain abscess symptoms that include headache, fever and chills, seizures, stiff neck, confusion or slowed thinking, vision changes, language problems, vomiting, and weakness on one side of the body.

These symptoms have many possible causes and do not mean someone has a fungal infection. MedlinePlus describes a brain abscess as a medical emergency that requires hospital care.

Specialized fungal tests are not routine. “Testing can be ordered through clinical reference laboratories,” the authors wrote, noting that these labs offer molecular fungal testing on tissue or cerebrospinal fluid samples.

The report urges prompt antifungal treatment and says surgical removal of the abscess, when possible, should be considered along with combination antifungal therapy. A three-drug combination of liposomal amphotericin B, posaconazole or voriconazole, and flucytosine given for at least two weeks has shown some effectiveness against the infection, though the most effective regimen is not known.

The authors called for more systematic reporting and urged clinical laboratories to publish case numbers. Until that happens, the true number of cases and the reason for the increase will remain uncertain.

What is Cladophialophora bantiana? It is a rare, dark-pigmented mold that tends to infect the brain, often causing abscesses. Published research links it to a 60% to 70% case-fatality rate.

How much have cases increased? Detections at one University of Washington reference lab rose about fourfold from 2023 to 2025, reaching 14 cases in 2025. The rate rose from an average of 8.4 per 1,000 specimens in 2017 to 2023 to 26 per 1,000 in 2025.

Which states reported cases? Cases came from 21 states and Washington, D.C. California, Florida, Texas, and Pennsylvania had the most.

Who gets infected? The median patient age was 68. The mold can infect people with healthy immune systems as well as those with weakened ones.

What symptoms should people watch for? Brain abscess symptoms include headache, fever, seizures, confusion, vision changes, and weakness on one side of the body.

Is it contagious? The report does not describe person-to-person spread. Infection is presumed to occur by breathing in the fungus or through a skin injury.