Background and Clinical Significance: Cladosporium cladosporioides is a ubiquitous dematiaceous mold that is rarely implicated in invasive human diseases and often considered a saprophyte and plant pathogen. Case Presentation: We report an extremely rare case of C. cladosporioides fungemia in a 61-year-old man with mantle cell lymphoma undergoing chemotherapy. The patient developed fever, dry cough and cavitary pulmonary lesions in the setting of profound immunosuppression. Blood cultures yielded slow-growing dark pigmented mold after prolonged incubation and species identification was achieved using MALDI-TOF mass spectrometry with an alternative fungal database, supported by microscopic morphology. Serum 1,3-β-D-glucan levels were markedly elevated, while galactomannan antigen testing was negative. Antifungal susceptibility testing demonstrated activity of triazoles and targeted therapy with voriconazole led to clinical improvement. A review of the literature identified only five previously reported cases of invasive C. cladosporioides infections worldwide, involving primarily pulmonary and central nervous system disease. Conclusions: To the best of our knowledge, this is the first documented case of fungemia caused by this species. The current report highlights the pathogenic potential of C. cladosporioides in immunocompromised hosts, the diagnostic challenges posed by slow-growing dematiaceous fungi, the importance of prolonged culture incubation, fungal biomarkers and advanced identification techniques for timely diagnosis and management.

Circulating histones are increasingly recognised as biologically relevant components of extracellular chromatin, but their composition and treatment-associated dynamics in acute myeloid leukaemia (AML) remain poorly defined. In this prospective single-centre observational study, we profiled 13 histone measures by ImageStream imaging flow cy-tometry in 31 plasma samples from 15 newly diagnosed AML patients at diagnosis/day 7/day 28 (n=15/10/6), with 30 healthy controls and 12 patients with myelodysplastic neoplasms with increased blasts. At diagnosis, nine of 13 measures differed from controls after false discovery rate (FDR) correction, defining a bidirectional profile with higher H2A-, H2B- and macroH2A1-associated measures and lower H3, H4 and H3/H4; the largest differences included in-creased macroH2A1.1 (7.07% vs. 0.47%; δ=0.98) and reduced H4 (0.14% vs. 3.25%; δ=−0.87). By day 7, five measures remained FDR-significant, all decreasing: H4, H3/H4 and the three tetrameric complexes. At day 28, no paired comparison remained FDR-significant; however, H3/H4 showed a significant overall temporal change across the six complete serial trajectories (q = 0.0334). Exploratory day-28 trajectories showed concordant decreases in all three tetrameric complexes in complete remission, with opposite changes in residual disease. MDS with increased blasts showed higher macroH2A1-containing tetrameric complexes than controls and AML. These findings support disease- and treatment-associated redistribution of circulating histone populations across myeloid neoplasia.