Cladophialophora bantiana: Infectious substances pathogen safety data sheet

Section I – Infectious agent


Cladophialophora bantiana

Agent type








Cladophialophora bantiana

Synonym or cross-reference

Previously named Torula bantiana, Cladosporium trichoides, Cladosporium trichoides var. chlamydosporum, Cladosporium bantianum, Xylohypha bantiana, Xylohypha emmonsii, and phaeophyphomycosisFootnote 1Footnote 2Footnote 3.


Brief description

C. bantiana is a dematiaceous, neurotropic fungus. Its brown/black appearance is due to dihydroxynaphthalene melanin in its cell wallFootnote 4. Conidia are oval-shaped, 1-5 μm x 1-2 μm, and form long, sparsely branched chainsFootnote 5Footnote 6. The DNA genome is approximately 37 Mbp in lengthFootnote 5.


Production of heat-stress proteins enable survival and growth of C. bantiana at temperatures up to 42 °CFootnote 7. C. bantiana produces melanin, which provides protection against oxidative stress, and may play a role in crossing the blood-brain barrierFootnote 8. The C. bantiana genome encodes several enzymes (e.g., superoxide dismutases, catalases) that neutralize reactive oxygen species, protecting the fungus against the host's immune responseFootnote 5.

Section II – Hazard identification

Pathogenicity and toxicity

The majority of C. bantiana infections affect the central nervous system (CNS), usually the brain, causing cerebral phaeophyphomycosisFootnote 3Footnote 9. Clinical characteristics of brain abscess due to C. bantiana include headache (56%-58%), hemiparesis (17%-54%), seizure (29%-32%), nausea and vomiting (22%), and fever (22%)Footnote 3Footnote 9. Infection of the meninges has been found in 12-14% of casesFootnote 3Footnote 9. Treatment for cerebral infection due to C. bantiana is often unsuccessful; the mortality rate is approximately 65%Footnote 3. Duration of illness can range from 16 days to 7 yearsFootnote 9. Recurrence of cerebral infection has been reported 2-6 months post-treatmentFootnote 9.

C. bantiana can also cause cutaneous or subcutaneous infectionFootnote 9Footnote 10, pulmonary infectionFootnote 9, sinusitis (1 case)Footnote 11, septic arthritis (1 case)Footnote 12, osteomyelitis (1 case)Footnote 13, and systemic disease affecting multiple organs. In some cases, infection can remain localized without dissemination to the CNSFootnote 5Footnote 8.

Rare instances of C. bantiana infections in animals including horses, cats, and dogs have been reportedFootnote 14. Infections are usually fatal; and often animals are euthanized before they succumb to infectionFootnote 14. C. bantiana has been implicated in equine rhinitis and sinusitisFootnote 15, and equine endometritisFootnote 14. Localized infections without CNS involvement, CNS infections, and systemic C. bantiana infections have been described in cats and dogsFootnote 14.


C. bantiana is found worldwide. Less than 200 cases of cerebral infection due to C. bantiana have been reported to date in 26 countries, including CanadaFootnote 3Footnote 9. Of these, 32% of cases were reported in India and 24% in the United StatesFootnote 9. Men are affected more frequently than womenFootnote 3Footnote 9.

Fewer than 20 cases have been reported for cats and dogsFootnote 14. Equine infections due to C. bantiana are rareFootnote 14Footnote 15.

Brain abscess due to C. bantiana affects both immunosuppressed and immunocompetent individualsFootnote 3. However, the mortality rate is higher for individuals with compromised immune status (e.g., organ transplant recipients, corticosteroid users) (77%) compared to immunocompetent individuals (56%)Footnote 3.

Host range

Natural host(s)

Humans, horsesFootnote 14, catsFootnote 14, dogsFootnote 14, snow leopardsFootnote 16, and alpacasFootnote 17.

Other host(s)

Mice, rabbits, and guinea pigs have been experimentally infectedFootnote 9Footnote 18.

Infectious dose


Incubation period

Approximately 3 to 8 weeks, but can be several years depending on infection route and dose. Shorter incubation periods occur when the infection site is closer to the brain or CNS regions, whereas longer incubation periods occur when infection sites are at a distance from the CNSFootnote 9Footnote 19.


C. bantiana can be transmitted via penetrating trauma where the fungus is inoculated directly into tissueFootnote 9Footnote 20. Inhalation of airborne conidia is suspected of being the main route of transmissionFootnote 9Footnote 18.

Section III – Dissemination


No animal reservoir has been identified. Environmental sources of C. bantiana are also not well established. C. bantiana has been isolated on rare occasions from soil, tree bark, and brick surfacesFootnote 21Footnote 22Footnote 23.


While C. bantiana can cause infection in both humans and animals, transmission from animals to humans, or from humans to animals, has not been documented to date.



Section IV – Stability and viability

Drug susceptibility/resistance

Amphotericin B; 5-flucytosine; azoles (e.g., voriconazole, fluconazole, itraconazole, isavuconazole, posaconazole, ketoconazole)Footnote 5Footnote 13; and echinocandins (e.g., caspofungin, anidulafungin, micafungin) have been used in the treatment of C. bantiana infectionFootnote 3Footnote 5. Other azole agents effective in vitro against C. bantiana include Syn-2869Footnote 24, SCH56592Footnote 25, and ravuconazoleFootnote 26. Terbinafine was also effective against C. bantiana in vitroFootnote 27Footnote 28.

Susceptibility to disinfectants

The susceptibility of C. bantiana to disinfectants is unknown. Other dematiaceous fungi are susceptible to chlorine (1%), biguanide (e.g., chlorhexidine) and quaternary ammonium compounds (e.g., benzalkonium chloride, cetrimide)Footnote 29Footnote 30.

Physical inactivation

Filamentous fungi are inactivated by moist heat treatment at 121 °C for 30 minutesFootnote 31. Other melanized fungi are inactivated by gamma radiation treatmentFootnote 32Footnote 33.

Survival outside host

Conidia of filamentous fungi can remain viable for prolonged periods. Other filamentous fungi survived after being stored for 12 months in sandFootnote 34.

Section V – First aid/medical


Diagnosis is accomplished through the monitoring of clinical symptoms. Magnetic resonance imaging or a computed tomography (CT) scan can be used to visualize lesions on the brainFootnote 9Footnote 35. Clinical specimens can be analysed by microscopy, culture, and molecular methods to detect C. bantiana. C. bantiana can be cultured on nutrient agar (e.g., Sabouraud dextrose agar) at 30 °CFootnote 5. Colonies appear velvety, with gray or brown pigment on the surface and a black undersideFootnote 5Footnote 14. Species-level identification can be achieved by PCR and sequencing the internal transcribed spacer region or 18S rRNAFootnote 9Footnote 14Footnote 16. Use of matrix assisted laser desorption ionization-time of flight (MALDI-TOF) mass spectrometry for identification of fungi is being explored, but databases are currently insufficient to identify many clinical speciesFootnote 36.

Note: The specific recommendations for surveillance in the laboratory should come from the medical surveillance program, which is based on a local risk assessment of the pathogens and activities being undertaken, as well as an overarching risk assessment of the biosafety program as a whole. More information on medical surveillance is available in the Canadian Biosafety Handbook (CBH).

First aid/treatment

Treatment of C. bantiana infections may involve administration of one or more antifungal drugsFootnote 9Footnote 14. For brain abscesses, surgical excision of the abscess and treatment with one or a combination of antifungal drugs may be recommendedFootnote 3Footnote 9.

Note: The specific recommendations for first aid/treatment in the laboratory should come from the post-exposure response plan, which is developed as part of the medical surveillance program. More information on the post-exposure response plan can be found in the CBH.


No vaccine is currently available.

Note: More information on the medical surveillance program can be found in the CBH, and by consulting the Canadian Immunization Guide.



Note: More information on prophylaxis as part of the medical surveillance program can be found in the CBH.

Section VI – Laboratory hazard

Laboratory-acquired infections

None have been reported to dateFootnote 14.

Note: Please consult the Canadian Biosafety Standard (CBS) and CBH for additional details on requirements for reporting exposure incidents. A Canadian biosafety guideline describing notification and reporting procedures is also available.


Biopsy specimens (e.g., brain, nasal, lung, skin), aspirated abscess contentsFootnote 9Footnote 14.

Primary hazards

Primary exposure hazards include autoinoculation with infectious material, inhalation of airborne conidia, and exposure of mucous membranes or wounded skin to infectious material.

Special hazards


Section VII – Exposure controls/personal protection

Risk group classification

C. bantiana is a Risk Group 3 (RG3) human pathogen and RG3 animal pathogenFootnote 37Footnote 38.

Containment requirements

Containment Level 3 facilities, equipment and operational practices outlined in the CBS for work involving infectious or potentially infectious materials, animals, or cultures.

Protective clothing

The applicable Containment Level 3 requirements for personal protective equipment (PPE) and clothing outlined in the CBS to be followed. At minimum, use of full body coverage dedicated protective clothing, dedicated protective footwear and/or additional protective footwear, gloves when handling infectious materials or animals, face protection when there is a known or potential risk of exposure to splashes or flying objects, respirators when there is a risk of exposure to infectious aerosols, and an additional layer of protective clothing prior to work with infectious materials or animals.

Note: A local risk assessment will identify the appropriate hand, foot, head, body, eye/face, and respiratory protection, and the personal protective equipment requirements for the containment zone must be documented.

Other precautions

All activities involving open vessels of infectious material are to be performed in a certified biological safety cabinet (BSC) or other appropriate primary containment device. The use of needles, syringes, and other sharp objects to be strictly limited. Additional precautions must be considered with work involving animals or large scale activities.

Section VIII – Handling and storage


Allow aerosols to settle. Wearing protective clothing, gently cover the spill with absorbent paper towel and apply suitable disinfectant, starting at the perimeter and working towards the centre. Allow sufficient contact time before clean up (CBH).


Regulated materials, as well as all items and waste to be decontaminated at the containment barrier prior to removal from the containment zone, animal room, animal cubicle, or post mortem room. This can be achieved by using decontamination technologies and processes that have been demonstrated to be effective against the infectious material, such as chemical disinfectants, autoclaving, irradiation, incineration, an effluent treatment system, or gaseous decontamination (CBH).


The applicable Containment Level 3 requirements for storage outlined in the CBS are to be followed. Primary containers of regulated materials removed from the containment zone to be stored in a labelled, leak-proof, impact-resistant secondary container, and kept either in locked storage equipment or within an area with limited access.

SSBA: Containers of security sensitive biological agents (SSBA) stored outside the containment zone must be labelled, leakproof, impact resistant, and kept in locked storage equipment that is fixed in place (i.e., non-movable) and within an area with limited access.

An inventory of RG3 and RG4 pathogens, and SSBA toxins in long-term storage, to be maintained and to include:

Section IX – Regulatory and other information

Canadian regulatory information

Controlled activities with C. bantiana require a Human Pathogens and Toxins Licence , issued by the Public Health Agency of CanadaFootnote 38.

The following is a non-exhaustive list of applicable designations, regulations, or legislations:

Last file update

October, 2019

Prepared by

Centre for Biosecurity, Public Health Agency of Canada.


The scientific information, opinions, and recommendations contained in this Pathogen Safety Data Sheet have been developed based on or compiled from trusted sources available at the time of publication. Newly discovered hazards are frequent and this information may not be completely up to date. The Government of Canada accepts no responsibility for the accuracy, sufficiency, or reliability or for any loss or injury resulting from the use of the information.

Persons in Canada are responsible for complying with the relevant laws, including regulations, guidelines and standards applicable to the import, transport, and use of pathogens in Canada set by relevant regulatory authorities, including the Public Health Agency of Canada, Health Canada, Canadian Food Inspection Agency, Environment and Climate Change Canada, and Transport Canada. The risk classification and related regulatory requirements referenced in this Pathogen Safety Data Sheet, such as those found in the Canadian Biosafety Standard, may be incomplete and are specific to the Canadian context. Other jurisdictions will have their own requirements.

Copyright © Public Health Agency of Canada, 2023, Canada


Footnote 1

McGinnis, M. R., D. Borelli, A. A. Padhye, and L. Ajello. 1986. Reclassification of Cladosporium bantianum in the genus Xylohypha. J. Clin. Microbiol. 23:1148-1151.

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Footnote 2

De Hoog, G. S., E. Guého, F. Masclaux, A. H. G. Gerrits van den Ende, K. J. Kwon-Chung, and M. R. Mcginnis. 1995. Nutritional physiology and taxonomy of human-pathogenic cladosporium-xylohypha species. Med. Mycol. 33:339-347.

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Footnote 3

Chakrabarti, A., H. Kaur, S. M. Rudramurthy, S. B. Appannanavar, A. Patel, K. K. Mukherjee, A. Ghosh, and U. Ray. 2016. Brain abscess due to Cladophialophora bantiana: a review of 124 cases. Med. Mycol. 54:111-119.

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Footnote 4

Badali, H., C. Gueidan, M. J. Najafzadeh, A. Bonifaz, A. H. G. Gerrits van den Ende, and G. S. de Hoog. 2008. Biodiversity of the genus Cladophialophora. Stud. Mycol. 61:175-191.

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Footnote 5

Kuan, C. S., C. Y. Cham, G. Singh, S. M. Yew, Y. C. Tan, P. S. Chong, Y. F. Toh, N. Atiya, S. L. Na, K. W. Lee, C. C. Hoh, W. Y. Yee, and K. P. Ng. 2016. Genomic Analyses of Cladophialophora bantiana, a Major Cause of Cerebral Phaeohyphomycosis Provides Insight into Its Lifestyle, Virulence and Adaption in Host. PLoS One. 11:e0161008.

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Footnote 6

Ahmad, M., D. Jacobs, H. H. Wu, D. M. Wolk, S. A. J. Kazmi, C. Jaramillo, and S. A. Toms. 2017. Cladophialophora Bantiana : A Rare Intracerebral Fungal Abscess-Case Series and Review of Literature. Surg. J. (N. Y). 3:e62-e68.

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Footnote 7

Huang, W. M., Y. M. Fan, W. Li, and W. W. Yang. 2011. Brain abscess caused by Cladophialophora bantiana in China. J. Med. Microbiol. 60:1872-1874.

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Footnote 8

Goralska, K., J. Blaszkowska, and M. Dzikowiec. 2018. Neuroinfections caused by fungi. Infection. 46:443-459.

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Footnote 9

Kantarcioglu, A. S., J. Guarro, S. De Hoog, H. Apaydin, and N. Kiraz. 2017. An updated comprehensive systematic review of Cladophialophora bantiana and analysis of epidemiology, clinical characteristics, and outcome of cerebral cases. Med. Mycol. 55:579-604.

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Footnote 10

Khader, A., B. Ambooken, M. P. Binitha, S. Francis, A. K. Kuttiyil, and D. N. Sureshan. 2015. Disseminated cutaneous phaeohyphomycosis due to Cladophialophora bantiana. Indian J. Dermatol. Venereol. Leprol. 81:491-494.

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Footnote 11

Brown, J. W.,3rd, J. Nadell, C. V. Sanders, and L. Sardenga. 1976. Brain abscess caused by Cladosporium trichoides (Bantianum): a case with paranasal sinus involvement. South. Med. J. 69:1519-1521.

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Footnote 12

Lim, A., D. Speers, and C. Inderjeeth. 2013. Cladophialophora (Xylohypha) bantiana--an unusual cause of septic arthritis. Rheumatology (Oxford). 52:958-959.

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Footnote 13

Desmet, S., L. Smets, K. Lagrou, I. Derdelinckx, J. Neyt, J. Maertens, R. Sciot, P. Demaerel, and B. Bammens. 2016. Cladophialophora bantiana osteomyelitis in a renal transplant patient. Med. Mycol. Case Rep. 12:17-20.

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Footnote 14

Rantala, M., S. Attia, P. Koukila-Kähkölä, S. De Hoog, M. Anttila, and T. Katila. 2015. Cladophialophora bantiana as an emerging pathogen in animals: Case report of equine endometritis and review of the literature. J. Clin. Microbiol. 53:3047-3053.

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Footnote 15

More, S. N., O. Hernandez, and W. L. Castleman. 2019. Mycotic Rhinitis and Sinusitis in Florida Horses. Vet. Pathol. 56:586-598.

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Footnote 16

Janovsky, M., A. Grone, D. Ciardo, J. Vollm, A. Burnens, R. Fatzer, and L. N. Bacciarini. 2006. Phaeohyphomycosis in a snow leopard (Uncia uncia) due to Cladophialophora bantiana. J. Comp. Pathol. 134:245-248.

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Footnote 17

Frank, C., R. Vemulapalli, and T. Lin. 2011. Cerebral phaeohyphomycosis due to Cladophialophora bantiana in a Huacaya alpaca (Vicugna pacos). J. Comp. Pathol. 145:410-413.

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Footnote 18

Dixon, D. M., W. G. Merz, H. L. Elliott, and S. Macleay. 1987. Experimental central nervous system phaeohyphomycosis following intranasal inoculation of Xylohypha bantiana in cortisone-treated mice. Mycopathologia. 100:145-153.

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Footnote 19

Kantarcioglu, A. S., J. Guarro, G. S. de Hoog, H. Apaydin, N. Kiraz, I. I. Balkan, and R. Ozaras. 2016. A case of central nervous system infection due to Cladophialophora bantiana. Rev. Iberoam. Micol. 33:237-241.

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Footnote 20

Maquine, G. A., M. H. G. Rodrigues, A. P. M. Schettini, P. M. Morais, and M. Z. M. Frota. 2019. Subcutaneous phaeohyphomycosis due to Cladophialophora bantiana: a first case report in an immunocompetent patient in Latin America and a brief literature review. Rev. Soc. Bras. Med. Trop. 52:e20180480-8682-0480-2018.

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Footnote 21

Vicente, V. A., D. Attili-Angelis, M. R. Pie, F. Queiroz-Telles, L. M. Cruz, M. J. Najafzadeh, G. S. de Hoog, J. Zhao, and A. Pizzirani-Kleiner. 2008. Environmental isolation of black yeast-like fungi involved in human infection. Stud. Mycol. 61:137-144.

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Footnote 22

Dixon, D. M., H. J. Shadomy, and S. Shadomy. 1977. Isolation of cladosporium trichoides from nature. Mycopathologia. 62:125-127.

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Footnote 23

Espinel-Ingroff, A., T. M. Kerkering, and H. J. Shadomy. 1982. Isolation of dematiaceous pathogenic fungi from a feed and seed warehouse. J. Clin. Microbiol. 15:714-719.

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Footnote 24

Johnson, E. M., A. Szekely, and D. W. Warnock. 1999. In vitro activity of Syn-2869, a novel triazole agent, against emerging and less common mold pathogens. Antimicrob. Agents Chemother. 43:1260-1263.

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Footnote 25

Espinel-Ingroff, A. 1998. Comparison of In vitro activities of the new triazole SCH56592 and the echinocandins MK-0991 (L-743,872) and LY303366 against opportunistic filamentous and dimorphic fungi and yeasts. J. Clin. Microbiol. 36:2950-2956.

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Footnote 26

Diekema, D. J., S. A. Messer, R. J. Hollis, R. N. Jones, and M. A. Pfaller. 2003. Activities of caspofungin, itraconazole, posaconazole, ravuconazole, voriconazole, and amphotericin B against 448 recent clinical isolates of filamentous fungi. J. Clin. Microbiol. 41:3623-3626.

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Footnote 27

McGinnis, M. R., and L. Pasarell. 1998. In vitro evaluation of terbinafine and itraconazole against dematiaceous fungi. Med. Mycol. 36:243-246.

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Footnote 28

Biancalana, F. S., L. Lyra, and A. Z. Schreiber. 2011. In vitro evaluation of the type of interaction obtained by the combination of terbinafine and itraconazole, voriconazole, or amphotericin B against dematiaceous molds. Antimicrob. Agents Chemother. 55:4485-4487.

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Footnote 29

Gupta, A. K., I. Ahmad, and R. C. Summerbell. 2002. Fungicidal activities of commonly used disinfectants and antifungal pharmaceutical spray preparations against clinical strains of Aspergillus and Candida species. Med. Mycol. 40:201-208.

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Footnote 30

Sandle, T., R. Vijayakumar, M. Saleh Al Aboody, and S. Saravanakumar. 2014. In vitro fungicidal activity of biocides against pharmaceutical environmental fungal isolates. J. Appl. Microbiol. 117:1267-1273.

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Footnote 31

Kowalski, W. 2012. Disinfection of the Inanimate Environment, p. 139. W. Kowalski (ed.), Hospital Airborne Infection Control. CRC Press.

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Footnote 32

da Silva, M., A. M. L. Moraes, M. M. Nishikawa, M. J. A. Gatti, M. A. Vallim de Alencar, L. E. Brandão, and A. Nóbrega. 2006. Inactivation of fungi from deteriorated paper materials by radiation. International Biodeterioration & Biodegradation. 57:163-167.

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Footnote 33

Saleh, Y. G., M. S. Mayo, and D. G. Ahearn. 1988. Resistance of some common fungi to gamma irradiation. Appl. Environ. Microbiol. 54:2134-2135.

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Footnote 34

Şahil, D., and F. Otag. 2013. Filamentous Fungi Isolated from Clinical Samples Stored for a Long Time in the Sand. Clin Microbiol. 2:1.

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Footnote 35

Velasco, J., and S. Revankar. 2019. CNS Infections Caused by Brown-Black Fungi. J. Fungi (Basel). 5:10.3390/jof5030060.

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Footnote 36

Singh, A., P. K. Singh, A. Kumar, J. Chander, G. Khanna, P. Roy, J. F. Meis, and A. Chowdhary. 2017. Molecular and Matrix-Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry-Based Characterization of Clinically Significant Melanized Fungi in India. J. Clin. Microbiol. 55:1090-1103.

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Footnote 37

Government of Canada. Jan 2019. ePATHogen - Risk Group Database. Feb 2019:.

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Footnote 38

Public Health Agency of Canada. 2018. Human Pathogens and Toxins Act (HPTA) (S.C. 2009, c.24).

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