Disseminated infection with Trichosporon beigelii

Two cases of systemic infection with Trichosporon beigelii are reported. Both patients had acute leukemia and were receiving cytotoxic and antibiotic drug therapy, which included amphotericin B, at the time of sepsis. Although clinical isolates of the organisms were found to be sensitive to amphotericin B in vitro, both patients died from severe, widespread fungal infection. The pathologic findings in these two cases suggest that the host response to trichosporon infection is a granulomatous inflammation. Trichosporon is a virulent opportunistic pathogen that may originate from the gastrointestinal tract damaged by cytotoxic therapy in the patient with aplasia. Despite aggressive antifungal therapy, survival is most closely related to recovery of the host's hematopoietic system.