Postoperative fungal endophthalmitis caused by Trichosporon asahii treated with voriconazole

Gonul, Saban; Gedik, Şansal; Öztürk, Bayram; Bakbak, Berker; Köktekir, Bengü Ekinci; Okudan, Süleyman; Dagi, Hatice Turk

doi:10.5935/0004-2749.20150065

Cited by 10 publications

(5 citation statements)

References 6 publications

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“…Furthermore, poorly controlled diabetes mellitus likely predisposed our patient to this infection, similarly as reported by Saban Gonul et al in their publication [5].…”

Section: Discussionsupporting

confidence: 83%

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Trichosporon Endophthalmitis Following Cataract Surgery: A Case Report

Thilagaraj¹,

Zahari²,

Sarojini³

et al. 2023

Cureus

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Fungal infections always pose a predicament to management and prognosis. The saprophytic fungus, Trichosporon inkin commonly causes endogenous infection in immunocompromised individuals. We report a case of exogenous T. inkin endophthalmitis successfully treated with voriconazole, pars plana vitrectomy, and removal of the source of infection. A 51-year-old gentleman with suboptimal control of diabetes presented with a right painful red eye for a week after undergoing an uneventful phacoemulsification with a posterior chamber intraocular lens implant more than a month prior. He presented with intense inflammation in the right anterior chamber that did not respond to steroid challenge. Ultrasound B scan showed vitreous opacities with no loculations. The culture of vitreous humor was negative. Systemic investigations were also normal. Despite being given multiple intravitreal antibiotics, his right eye got worse. He then underwent vitrectomy and intraocular lens explantation, in which the culture of the lens grew Trichosporon Inkin. He was subsequently started on the appropriate antifungals (topical, intravitreal, and systemic) based on the minimum inhibitory concentration of the antifungal sensitivity test. The patient eventually showed significant clinical improvement, and intraocular inflammation was subsiding after six months of treatment. His best corrected visual acuity improved to 6/12 with Snellen's visual acuity chart.

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“…Furthermore, poorly controlled diabetes mellitus likely predisposed our patient to this infection, similarly as reported by Saban Gonul et al in their publication [5].…”

Section: Discussionsupporting

confidence: 83%

“…There are reports of exogenous endophthalmitis caused by Trichosporon asahii and cutaneoum with positive cultures acquired from the intraocular lens and structures of the enucleated eye, respectively [ 3 , 5 ]. As stated earlier, this species of fungi is a commensal of the skin, including the hair follicles.…”

Section: Discussionmentioning

confidence: 99%

Trichosporon Endophthalmitis Following Cataract Surgery: A Case Report

Thilagaraj¹,

Zahari²,

Sarojini³

et al. 2023

Cureus

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“…Studies showed that voriconazole was the rst choice for drug treatment of a. asasicum, followed by itraconazole and uconazole [21][22][23][24], and drug resistance to carpofennet and amphotericin B [25][26][27]. Some reports suggest that there are regional differences in sensitivity to amphotericin B, with most drug resistance in foreign countries, but still sensitivity in mainland China [25,27].…”

Section: Discussionmentioning

confidence: 99%

Clinical Characteristics of Community-acquired Pneumonia due to Infection with Trichosporon asahii

Zhang¹,

Qiao

2021

Preprint

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Objectives: The aim of this study was to evaluate the clinical characteristics of community-acquired pneumonia (CAP) patients with infected Trichosporon asahii in urinary tract .Methods: Patients diagnosed with Trichosporon asahii isolated from the patients with urinary tract infection between January 2015 and November 2019, were retrospectively reviewed in this study. Clinical data were collected for each patient, including age, gender, co-morbid diseases,relevant tests,antimicrobial susceptibility test and impact on patient’s antifungal drugs , etc.Results: Ten patients (9 males and 1 female; range of age: 63–91, and average age of 80.1) were enrolled into this study. Of the ten patients, ten patient had old cerebral infarction, ten patient had coronary heart disease, five patient had hypertension, three patient had diabetes, three patient had gastrointestinal bleeding, one patient had lung cancer.Of the ten enrolled patients, all patients were suffering from cough and sputum, and five patients were presented with fever. However, there were no urinary tract symptoms such as frequent urination, urgency and pain. No complications occurred. Furthermore, all patients had increased C-reactive protein (CRP), only three patients had increased white blood cell (WBC). At the same time, nine had decreased albumin (ALB),seven had percentage of eosinophils(EO%),and five had helper T lymphocytes(CD4). All patients were treated with anti-infection,and expectorant.Among antifungal drugs, amphotericin and voriconazole have higher sensitive rate.Finally, five patients were discharged with a better health condition, two patients were automatically discharged, and three patients were died.The average follow-up for patients was 3 months.,three patients were died.Conclusions: The results suggested that the mortality rate of Trichosporon asahii pneumonia is very high, therefore, patients with infected Trichosporon asahii should be more actively treated by antifungal drug such as voriconazole.

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“…Once trichosporonosis has established in tissue, recurrence is common even with prolonged antifungal treatment of up to 2 years. 8,9 In this case, duration of intravenous antimicrobial treatment was guided by clinical improvement and monitoring of inflammatory markers; we switched intravenous to oral treatment approximately 1 month after all inflammatory markers (C-reactive protein [CRP], procalcitonin, erythrocyte sedimentation rate [ESR]) in our patient had normalised. Treatment in this case was complicated by initial intolerance to voriconazole, requiring a switch to a regimen that was potentially less effective (amphotericin and fluconazole).…”

Section: Discussionmentioning

confidence: 99%