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Invasive Trichosporon cutaneum infection: an increasing problem in immunosuppressed patients

R M Lowenthal1, K Atkinson, D R Challis

  • 1Department of Medicine, University of Tasmania, Hobart, Australia.

Bone Marrow Transplantation
|October 1, 1987
PubMed

Insights

Trichosporon cutaneum infections are a serious threat to immunocompromised patients, especially after bone marrow transplants. This case highlights that early diagnosis and treatment can lead to recovery, even with invasive pulmonary infection and fungemia.

Area of Science:

  • Mycology
  • Infectious Diseases
  • Hematology

Background:

  • Trichosporon cutaneum, a soil saprophyte, is an emerging cause of severe systemic infections.
  • Immunosuppressed patients, particularly bone marrow transplant recipients, are at high risk.
  • The literature reports a high mortality rate for invasive Trichosporon infections.

Observation:

  • A 44-year-old male bone marrow transplant recipient developed invasive pulmonary infection and fungemia.
  • Symptoms included severe respiratory distress and hypoxemia with a clear chest X-ray.
  • Diagnosis was confirmed by lung aspirate and blood cultures identifying fungal hyphae.

Findings:

  • The patient recovered despite the severe presentation and high-risk status.
  • Successful treatment involved a combination of amphotericin B, miconazole, and ketoconazole.
  • This case challenges the previously reported high mortality rates for such infections.

Implications:

  • Trichosporon cutaneum should be recognized as a treatable pathogen in severely immunocompromised individuals.
  • Prompt diagnosis and multi-agent antifungal therapy are crucial for improving outcomes.
  • Further research into effective treatment strategies for invasive Trichosporon infections is warranted.

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