Systemic infection caused by<i>Trichosporon asahii</i>in a patient with liver transplant

Biasoli, Marisa; Carlson, Damián; Chiganer, Gastón J.; Parodi, Roberto; Greca, Alcides; Tosello, María Elena; Luque, Alicia G.; Montero, Antonio

doi:10.1080/13693780802232928

Cited by 26 publications

(18 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Our results are nearly consistent with a previous case study by Pereira et al, [14,15] who reported anemia, thrombocytopenia and metabolic acidosis in a low birth weight preterm baby with T. asahii fungemia [16] recently reported severe throbmocytopenia, lethargy, feeding intolerance, bleeding manifestations in cases of T. asahii fungemia in preterm babies with low birth weight. Unexplained thrombocytopenia was again reported by John et al, [17] in an immunocompetent adult patient with T. asahii fungemia.…”

Section: Discussionsupporting

confidence: 83%

A Trichosporon asahii Bloodstream Infection in a Preterm Newborn with a Successful Outcome: A Case Report

Ma¹,

Sam²,

El-Shalakany³

et al. 2017

J Blood Lymph

View full text Add to dashboard Cite

Trichosporon asahii is a rare opportunistic fungal pathogen that causes fatal systemic infections in immunocompromised patients. We have reported a case of T. asahii fungemia in a low birth weight preterm newborn baby in the neonatal intensive care unit (NICU). This case of T. asahii fungemia was unresponsive to treatment with a combination of Amphotericin B and Fluconazole. However, Treatment with a combination of Voriconazole and Caspofungin was successfully eliminated the fungus from the blood of the infected patient.

show abstract

Section: Discussionsupporting

confidence: 83%

A Trichosporon asahii Bloodstream Infection in a Preterm Newborn with a Successful Outcome: A Case Report

Ma¹,

Sam²,

El-Shalakany³

et al. 2017

J Blood Lymph

View full text Add to dashboard Cite

show abstract

“…T. asahii has extensively been recognized as an emergent agent of fungal invasive infections worldwide (4,5,19,20,28,30,46,51,53). The largest multicentric restrospective study addressing Trichosporon invasive infections found that T. asahii accounted for 15 of 30 isolates (50%) identified to the species level (15).…”

Section: Discussionmentioning

confidence: 99%

Bloodstream Infections Due to Trichosporon spp.: Species Distribution, Trichosporon asahii Genotypes Determined on the Basis of Ribosomal DNA Intergenic Spacer 1 Sequencing, and Antifungal Susceptibility Testing

et al. 2009

View full text Add to dashboard Cite

The reevaluation of the genus Trichosporon has led to the replacement of the old taxon Trichosporon beigelii by six new species. Sequencing of the ribosomal DNA (rDNA) intergenic spacer 1 (IGS1) is currently mandatory for accurate Trichosporon identification, but it is not usually performed in routine laboratories. Here we describe Trichosporon species distribution and prevalence of Trichosporon asahii genotypes based on rDNA IGS1 sequencing as well as antifungal susceptibility profiles of 22 isolates recovered from blood cultures. The clinical isolates were identified as follows: 15 T. asahii isolates, five Trichosporon asteroides isolates, one Trichosporon coremiiforme isolate, and one Trichosporon dermatis isolate. We found a great diversity of different species causing trichosporonemia, including a high frequency of isolation of T. asteroides from blood cultures that is lower than that of T. asahii only. Regarding T. asahii genotyping, we found that the majority of our isolates belonged to genotype 1 (86.7%). We report the first T. asahii isolate belonging to genotype 4 in South America. Almost 50% of all T. asahii isolates exhibited amphotericin B MICs of >2 g/ml. Caspofungin MICs obtained for all the Trichosporon sp. isolates tested were consistently high (MICs > 2 g/ml). Most isolates (87%) had high MICs for 5-flucytosine, but all of them were susceptible to triazoles, markedly to voriconazole (all MICs < 0.06 g/ml).The incidence of invasive mycoses caused by emergent fungal pathogens has risen considerably over the last two decades. This fact is related to several factors, including the increased occurrence of degenerative and malignant diseases in different populations, as well as the higher number of patients exposed to organ transplantation, immunosuppressive therapies, chemotherapy, broad-spectrum antibiotics, and invasive medical procedures. It is important to emphasize that emergent fungal infections are usually difficult to diagnose, refractory to conventional antifungal drugs, and associated with high mortality rates (8,10,26,32,34,47,51).Invasive infections caused by Trichosporon spp. are reported mostly for cancer patients that have central venous catheters (22,(50)(51)(52). Although trichosporonemia represents a small percentage of all fungal invasive infections, Trichosporon spp. have been reported as the second-or third-most-common agents of yeast fungemia (13,21,51).Phenotypic methods for Trichosporon species identification usually generate inconsistent results, and none of the commercial tests available include the whole new taxonomic categories in their databases (1, 36, 37). For instance, it has been mentioned in the literature that an isolate identified by molecular methods as Trichosporon dermatis was mistakenly identified as Trichosporon mucoides when Vitek Systems 1 and 2 (BioMérieux, France) were used (16). Furthermore, Ahmad et al.(1) reported that four isolates previously identified by Vitek 2 as Trichosporon asahii were identified as Trichosporon asteroides by molecular technique...

show abstract

“…Trichosporon ovoides, Trichosporon cutaneum, Trichosporon inkin, and Trichosporon asteroides are responsible for superficial skin lesions. Trichosporon asahii and Trichosporon mucoides have been described as agents of invasive diseases in leukemic patients and more recently in liver, kidney, or heart transplant patients (1,3,6,10,14,15,16,20). One case of fungal arteritis with arterial anastomotic dehiscence after kidney transplantation has been reported (5).…”

Section: Case Reportmentioning

confidence: 99%

Disseminated Trichosporon mycotoxinivorans, Aspergillus fumigatus, and Scedosporium apiospermum Coinfection after Lung and Liver Transplantation in a Cystic Fibrosis Patient

et al. 2012

View full text Add to dashboard Cite

Trichosporon mycotoxinivorans is a novel pathogen recently found in cystic fibrosis patients. We report the first case of a disseminated fatal infection with T. mycotoxinivorans associated with invasive Aspergillus fumigatus and Scedosporium apiospermum infection after lung and liver transplantation in a cystic fibrosis patient. CASE REPORTA 35-year-old man with cystic fibrosis (CF) was admitted for rapid respiratory deterioration and high-level oxygen requirements with respiratory acidosis. He was a nonsmoker and was still working actively as a farmer until a few days before his admission. His past medical history included sinonasal polyposis and diabetes mellitus. He was in good general condition despite a severe obstructive pulmonary disease that had been stable over the previous 5 years, with a forced expiratory volume in the first second at 20% of that predicted. He also had a 5-year bronchial colonization with Pseudomonas aeruginosa and Aspergillus fumigatus.Because of respiratory deterioration despite noninvasive ventilation and antibiotics, an extracorporeal membrane oxygenation, inotropic support, and hemodialysis were started and an emergency double lung transplantation (LT) was performed. The immunosuppression included basiliximab and high-dose methylprednisolone for induction, a standard dose of tacrolimus, mycofenolate mofetil, and methylprednisolone for maintenance. Due to immediate postoperative acute liver failure, an emergency liver transplantation was performed on day 2 post-LT. Another dose of basiliximab and high dose of methylprednisolone were given. Antifungal prophylaxis with caspofungin (70 mg) started on the day of LT was discontinued the next day due to liver dysfunction. Amyloidosis AA (deposition of amyloid protein A) was diagnosed on explanted liver. The patient's condition remained stable, although invasive ventilation and hemodialysis were maintained. Routine bronchoalveolar lavage specimens at days 1 and 6 post-LT were positive for P. aeruginosa (treated with ceftazidime, ciprofloxacin, and meropenem) and A. fumigatus. Caspofungin was resumed (50 mg daily) at day 6 post-LT because an Aspergillus galactomannan detection test (Platelia Aspergillus antigen; Bio-Rad) became positive in serum.On day 9 post-LT, nonfebrile sleepiness was noted. Within 4 days, the neurologic condition worsened, with tetraparesis and coma. Cerebral magnetic resonance imaging (MRI) showed multiple foci of cortical, subcortical, and periventricular hyperinten-

show abstract

Systemic infection caused byTrichosporon asahiiin a patient with liver transplant

Cited by 26 publications

References 30 publications

A Trichosporon asahii Bloodstream Infection in a Preterm Newborn with a Successful Outcome: A Case Report

A Trichosporon asahii Bloodstream Infection in a Preterm Newborn with a Successful Outcome: A Case Report

Bloodstream Infections Due to Trichosporon spp.: Species Distribution, Trichosporon asahii Genotypes Determined on the Basis of Ribosomal DNA Intergenic Spacer 1 Sequencing, and Antifungal Susceptibility Testing

Disseminated Trichosporon mycotoxinivorans, Aspergillus fumigatus, and Scedosporium apiospermum Coinfection after Lung and Liver Transplantation in a Cystic Fibrosis Patient

Contact Info

Product

Resources

About