Disseminated Cutaneous Trichosporonosis in an Adult Bone Marrow Transplant Patient

Area of Science:

• Medical Mycology
• Infectious Diseases
• Hematology

Background:

• Opportunistic fungal infections pose a significant threat to immunocompromised individuals.
• Trichosporon species, particularly Trichosporon asahii, are known pathogens, primarily documented in pediatric bone marrow transplant recipients.
• Limited data exists on the incidence and clinical presentation of Trichosporon asahii infections in adult patients.

Observation:

• A 52-year-old woman with acute myeloid leukemia undergoing allogeneic bone marrow transplant developed persistent non-neutropenic fever.
• Initial presentation suggested hepatosplenic candidiasis, treated with fluconazole and anidulafungin without resolution.
• Dusky nodules on limbs and histopathological findings confirmed Trichosporon asahii infection.

Findings:

• Diagnosis of Trichosporon asahii infection was confirmed through histopathology and fungal culture.
• The patient received oral voriconazole, which resulted in complete resolution of skin lesions.
• This case highlights a rare adult presentation of Trichosporon asahii infection.

Implications:

• Increased clinical suspicion for Trichosporon asahii is crucial in adult immunocompromised patients, especially those with persistent fever and skin lesions.
• Voriconazole is an effective first-line treatment for Trichosporon infections.
• This case underscores the importance of considering less common pathogens in the differential diagnosis of febrile syndromes in transplant recipients.