Disseminated Trichosporon asahii infection in a combined liver‐kidney transplant recipient successfully treated with voriconazole

Abstract

Introduction Trichosporon asahii is an emerging cause of systemic fungal infection in an immunocompromised host. Several life threatening disseminated T. asahii infection in single solid organ (liver or kidney) transplant recipients, in neutropenic and hematological malignancy patients have been reported. Case presentation (Methods and Results) A 49‐year old gentleman who underwent simultaneous living‐donor liver transplantation (donor sister) and kidney transplant (donor wife) developed fever and subsegmental patchy consolidation with right sided pleural effusion on fourth postoperative day. Central line blood stream infection was suspected. Blood culture grew creamy white colonies of T. asahii on blood agar with characteristic dirty‐green colonies on CHROMagar. Laboratory analysis of pleural fluid also revealed budding yeast cells identified as T. asahii. Microscopy of the isolates showed hyphae, arthroconidia, and blastospores. The isolates were identified as T. asahii by VITEK MS which uses matrix‐assisted laser desorption/ionization time‐of‐flight (MALDI‐TOF) technology. Initially liposomal amphotericin B and micafungin was initiated, but due to lack of clinical and microbiological response, patient was switched to voriconazole. Simultaneously, tacrolimus doses were reduced to one‐third in view of interaction with voriconazole. Subsequently, patient improved with resolution of fever and microbiological cure. Conclusion This is the first case report of disseminated T. asahii infection in a combined liver‐kidney transplant recipient successfully treated with voriconazole. Azole antifungal are the promising drug of choice for systemic T. asahii infection. Drug interactions should be considered while using these antifungal agents.

Counting and identification of molds and yeasts in dry salted shrimp commercialized in Rio Branco, Acre, Brazil

“…Malassezia is reported as a commensal for the skin of humans and animals, but can result in pityriasis versicolor, with the development of seborrheic and atopic dermatitis (Choi et al, 2020). Both fungal genera are considered opportunistic and are more detrimental in immunocompromised hosts, which can even result in septicemia (Challapilla et al, 2019;Sah et al, 2019).…”

Molecular phylogeny and morphological characterization of the aetiological agent of sour rot on fruits and vegetables in Brazil

“…mangostana in Belem. There are reports concerning infections for some Trichosporon species, especially in immunocompromised patients with leukemia (Ramírez & Moncada, 2020) and liver and kidney transplant patients (Sah et al, 2019), which cause a disease called trichosporonosis (Ozkaya‐Parlakay et al, 2016), but not as a postharvest pathogen for G . mangostana .…”

Trichosporon asahii and Trichosporon inkin Biofilms Produce Antifungal-Tolerant Persister Cells

“…are ubiquitous fungi, commonly found as commensals of the human skin and gastrointestinal tract (Duarte-Oliveira et al, 2017). Trichosporon species are emerging opportunistic fungi that have been increasingly reported as agents of fungemia in the last years, especially in immunocompromised patients (Challapilla et al, 2019;Sah et al, 2019;Alp et al, 2020). Furthermore, Trichosporon species have been reported as the second leading cause of invasive yeast infection in patients with malignant hematological diseases (Almeida and Hennequin, 2016).…”