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Chemoport-related Fungemia Caused by Trichosporon asahii

Dona S Raju1, Aadharsa Sugunan1, Pavithran Keechilattu2

  • 1Department of Pharmacy Practice, Amrita School of Pharmacy.

Journal of Pediatric Hematology/Oncology
|January 25, 2019
PubMed

Insights

This case study highlights a rare fungal sepsis caused by Trichosporon asahii in a young child with Wilms tumor. Prompt treatment with voriconazole successfully cleared the invasive fungal infection.

Area of Science:

  • Mycology
  • Infectious Diseases
  • Pediatric Oncology

Background:

  • Trichosporon asahii is an opportunistic fungal pathogen causing severe infections in immunocompromised individuals.
  • Neutropenia, often associated with malignancies like Wilms tumor, is a significant risk factor for invasive fungal infections.
  • Invasive T. asahii infections can manifest as disseminated or localized forms, with the disseminated type being more common in neutropenic patients.

Observation:

  • A 1-year-old child diagnosed with Wilms tumor presented with high spiking fever and neutropenia.
  • Blood cultures identified an invasive fungal infection caused by Trichosporon asahii.
  • This represents the first reported case of T. asahii fungal sepsis in a patient with Wilms tumor.

Findings:

  • The patient received intravenous voriconazole for the invasive fungal infection.
  • Following 14 days of voriconazole treatment, T. asahii was eradicated from the patient's bloodstream.
  • This case demonstrates the successful management of a rare fungal sepsis in a pediatric oncology patient.

Implications:

  • The increasing incidence of rare invasive fungal infections in immunocompromised patients necessitates awareness and prompt diagnosis.
  • Antifungal susceptibility patterns in rare fungi can be heterogeneous, complicating treatment strategies.
  • Early and appropriate antifungal therapy, such as voriconazole, is crucial for managing invasive Trichosporon asahii infections in vulnerable pediatric populations.

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