Chemoport-related Fungemia Caused by Trichosporon asahii

Abstract

Trichosporon asahii is a rare opportunistic fungal pathogen that causes fatal systemic infection in immunocompromised patients. Neutropenia developing due to malignancies is an important risk factor for fungal infection. Invasive infections due to T. asahii can be divided into disseminated and localized forms. The disseminated form is more common and usually occurs in neutropenic patients. The patient typically has an acute febrile illness that progresses rapidly to multiorgan failure. Here, we are presenting a case of fungal sepsis by invasive T. asahii in a 1-year-old child with Wilms Tumor. To the best of our knowledge, this is the first time that fungal sepsis due to T. asahii has been reported in a Wilms tumor patient. The incidence of rare invasive fungal infections is increasing in immunocompromised patients in whom management becomes difficult due to their heterogenous antifungal susceptibility pattern and intrinsic resistance to the standard antifungal agents that are routinely given. The patient was admitted with high spiking fever, and his laboratory investigations suggested neutropenia. T. asahii was isolated from the blood culture, for which he was started on inj. voriconozole. After 14 days of treatment, the fungus was cleared out from the patient’s blood.

Invasive Trichosporonosis in Neonates and Pediatric Patients with Malignancies or Hematologic Disorders

“…The most common underlying disorder was acute lymphoblastic leukemia (ALL) (13/32; 41%) followed by acute myeloid leukemia (AML) (8/32 cases; 25%). The remaining 34% of the reported cases included three cases with aplastic anemia, two cases with mixed ALL and one case with Blackfan-Diamond, myelodysplastic syndrome (MDS), Langerhans cell histiocytosis, Wilms tumor, Ewing sarcoma and yolk sac tumor, respectively [38,[41][42][43][44][45][46][47][48][49][50][51][52][53][54][55][56][57][58][59]. The male/female ratio was 1/1.…”

Invasive Trichosporonosis in Neonates and Pediatric Patients with Malignancies or Hematologic Disorders

“…The most common underlying disorder was acute lymphoblastic leukemia (ALL) (13/32; 41%) followed by acute myeloid leukemia (AML) (8/32 cases; 25%). The remaining 34% of the reported cases included 3 cases with aplastic anemia, 2 cases with mixed ALL and one case with Blackfan-Diamond, myelodysplastic syndrome, Langerhans cell histiocytosis, Wilms tumor, Ewing sarcoma and yolk sac tumor, respectively [40,[43][44][45][46][47][48][49][50][51][52][53][54][55][56][57][58][59][60][61]. The male/female ratio was 1/1.…”

A Case of Fatal Invasive Trichosporonosis in the Setting of Immunosuppression and Post-COVID-19 Pneumonia

“…They classically behave as opportunistic pathogens, and of the 50 species of Trichosporon described so far, only 16 have been found to be pathogenic [ 3 ]. The six species primarily associated with human infection are Trichosporon asahii , Trichosporon asteroides , Trichosporon cutaneum , Trichosporon inkin , Trichosporon mucoides , and Trichosporon ovoides , which have been implicated in cutaneous, pulmonary, and systemic infections [ 4 - 5 ].…”

“…In addition, one of the biggest risk factors for trichosporonosis is hematologic disease or malignancy, which has been reported to account for 38.9-63% of cases in various studies [ 4 , 6 ]. Other risk factors reported for T. asahii infection specifically include IV catheters, AIDS, glucocorticoid treatment, and extensive burns [ 5 ].…”