Fungemia due to Trichosporon asahii in a Neutropenic Child Refractory to Amphotericin B

Abstract

Disseminated Trichosporon infection in neutropenic patients carries a poor prognosis. Clinical evidence on the use of voriconazole for this infection is limited. The authors report a case of Trichosporon asahii fungemia refractory to liposomal amphotericin B treatment in a boy with acute lymphoblastic leukemia, which resolved after the addition of voriconazole. Both voriconazole and amphotericin B exhibited low minimal inhibitory concentrations and minimal fungicidal concentrations, and their combination was indifferent in vitro. The use of voriconazole for the treatment of trichosporonosis in patients with hematologic malignancies deserves further study.

Multilaboratory Testing of Two-Drug Combinations of Antifungals against Candida albicans , Candida glabrata , and Candida parapsilosis

“…The format of the checkerboard dilution method for antimicrobial combination testing is familiar to clinical laboratories that already use CLSI broth microdilution methods for antifungal testing (13). There have been previous reports to indicate that the laboratory evidence of synergy between antifungal combinations based upon ⌺FICs derived from checkerboard dilutions could be successfully correlated with clinical evidence of optimal outcomes in recalcitrant yeast infections (4,21,47). Earlier reports of antibacterial combination testing also indicated that FICs derived from checkerboard dilutions provide good predictions of bactericidal activity (31,45).…”

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

“…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). Members of the genus Trichosporon have occasionally been implicated as nail pathogens (16,28,74) and in subcutaneous infections (66).…”

Disseminated Trichosporonosis in a Burn Patient: Meningitis and Cerebral Abscess Due to Trichosporon asahii

“…In vitro resistance to amphotericin B and, to a lesser extent, the azoles has been demonstrated (24). However, the newer triazoles (e.g., voriconazole, posaconazole, ravuconazole) have shown excellent in vitro activity against Trichosporon species and are recommended for treatment (1,6,21). A review of the patient's record revealed that no antifungal drugs were used in her management, a decision apparently made in the face of negative blood cultures and because dissemination of the fungus at the time was not indicated by early investigations.…”