Breakthrough trichosporonosis in patients with acute myeloid leukemia receiving micafungin

Molecular Identification and Susceptibility ofTrichosporonSpecies Isolated from Clinical Specimens in Qatar: Isolation ofTrichosporon dohaenseTaj-Aldeen, Meis & Boekhout sp. nov

“…For most of the Trichosporon isolates in our study, high amphotericin B MICs were found, confirming previous results. Although echinocandins are increasingly regarded as the preferred treatment choice for candidemia in patients with severe sepsis and septic shock (58), clinical failure and breakthrough infections with Trichosporon have been reported with the use of caspofungin and micafungin (3,7). In this study, caspofungin and anidulafungin demonstrated no in vitro activity against Trichosporon species.…”

“…Disseminated Trichosporon infections are potentially lifethreatening and are often fatal in neutropenic patients (7,22). Although uncommon, pathogenic species of this genus have been reported increasingly, mostly in patients with malignant diseases (3,6,9,10,11,20,32,44,47,48,63,77), neonates (18,56,84), a bone marrow transplant recipient (22), a solid organ transplant recipient (50), and patients with human immunodeficiency virus (34,35,46). Trichosporon has also been reported to cause fungemia (5,9,25,29,30,33,53,62).…”

Breakthrough disseminated zygomycosis induced massive gastrointestinal bleeding in a patient with acute myeloid leukemia receiving micafungin

“…For example, breakthrough trichosporonosis related to micafungin is well known. 10,11 Micafungin is a newly approved antifungal agent in the echinocandin class that inhibits the synthesis of 1, 3-β-D-glucan, an essential fungal cell-wall component. Because of its safety and broad spectrum of activity, including against Candida and Aspergillus sp., micafungin is widely used in Japan.…”

Breakthrough cryptococcosis in a patient with systemic lupus erythematosus (SLE) receiving micafungin

“…Recently, breakthrough trichosporonosis has become a signifi cant problem in patients with hematological malignancies who are receiving echinochandins. 3,4 In our patient, because of her immunosuppressive state, micafungin was intravenously administered, together with a broadspectrum antibiotic (meropenem) for 14 days as empiric therapy for fungal and bacterial infections, respectively. While these agents were being administered, the patient developed several CNS symptoms, which were later confi rmed to have been caused by cryptococcal meningitis.…”

“…1,2 Among such infections, breakthrough trichosporonosis is becoming a signifi cant problem in patients with hematological malignancies who are receiving echinocandin class antifungal agents, especially micafungin. 3,4 Here, we report a patient with systemic lupus erythematosus (SLE) who developed disseminated cryptococcosis while receiving micafungin as an empiric antifungal therapy.…”