Use of combination therapy to successfully treat breakthrough Trichosporon asahii infection in an acute leukemia patient receiving voriconazole

Abstract

Trichosporon species is an important life-threatening opportunistic systemic pathogen, especially in leukemia patients. Voriconazole is proved to be a promising agent in past decade. However, recently we observed a case of breakthrough Trichosporon asahii infection while receiving voriconazole, which calls for an alternative treatment strategy. A combination therapy of liposomal amphotericin B (AmB) plus caspofungin – in which liposomal AmB dose was reduced due to renal toxicity – was administered to successfully treat this patient.

Successful treatment of breakthrough disseminated Trichosporon asahii fungemia in a patient with acute myeloid leukemia receiving itraconazole prophylaxis

“…Based on these reports, azoles are considered as optimal treatments for trichosporonosis. On the other hand, some reports and the present case showed breakthrough Trichosporon infection in patients with neutropenia receiving azoles [8] , [9] , [10] . Our case received L-AMB, to which Trichosporon species have been reported to show low susceptibility [5] .…”

“…While it is well-known that breakthrough trichosporonosis develops in patients with hematologic malignancies receiving echinocandin [6] , [7] , we encountered a patient with breakthrough T. asahii fungemia while taking itraconazole (ITCZ) as prophylaxis. Since only sporadic cases of breakthrough trichosporonosis have been reported in patients receiving azoles [8] , [9] , [10] , we herein describe the clinical course of our case.…”

Invasive Trichosporon Infection: a Systematic Review on a Re-emerging Fungal Pathogen

“…For comparison analysis, the cases were clustered according to the main underlying disease, e.g., homeopathy ( n = 79; Grauer et al, 1994 ; Higgins et al, 1994 ; Hsiao et al, 1994 ; Nasu et al, 1994 ; Hung et al, 1995 ; Spánik et al, 1995 ; Itoh et al, 1996 ; Fanci et al, 1997 ; Kataoka-Nishimura et al, 1998 ; Sklair-Levy et al, 1998 ; Krcmery et al, 1999 ; Takamura et al, 1999 ; Erer et al, 2000 ; Kim et al, 2001 ; Moretti-Branchini et al, 2001 ; Fournier et al, 2002 ; Hadley et al, 2002 ; Meyer et al, 2002 ; Chang et al, 2003 ; Marty et al, 2003 ; Bassetti et al, 2004 ; Chowdhary et al, 2004 ; Viscomi et al, 2004 ; Antachopoulos et al, 2005 ; Chan-Tack, 2005 ; Akagi et al, 2006 ; Ghiasian et al, 2006 ; Kendirli et al, 2006 ; Koyanagi et al, 2006 ; Matsue et al, 2006 ; Meguro-Hashimoto et al, 2006 ; Rodrigues et al, 2006 ; Hara et al, 2007 ; Miura et al, 2007 ; Rieger et al, 2007 ; Bayramoglu et al, 2008 ; Hosoki et al, 2008 ; Thibeault et al, 2008 ; Tsuji et al, 2008 ; Fekkar et al, 2009 ; Walia et al, 2009 ; Gabriel et al, 2011 ; Kudo et al, 2011 ; Hosokawa et al, 2012 ; Menezes et al, 2012 ; Chen et al, 2014 ; Issarachaikul et al, 2014 ; Karapinar et al, 2014 ; Capoor et al, 2015 ; Odero et al, 2015 ; Pérard et al, 2015 ; Tanyildiz et al, 2015 ), other immunodeficiency conditions ( n = 41; Canales et al, 1998 ; Lascaux et al, 1998 ; Anuradha et al, 2000 ; Piwoz et al,…”

Catheter-Related Trichosporon asahii Bloodstream Infection in a Neutropenic Patient with Myelodysplastic Syndrome

“…On the basis of a head-to-head comparison of five triazoles, voriconazole showed the best therapeutic effect in terms of in vitro and in vivo activities and good results for treating disseminated T. asahii infection [ 14 ]. The combination of voriconazole with amphotericin B or echinocandin appears to have some synergistic antifungal effects in some reports [ 15 ].…”