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Published on: March 22, 2012
Detection of invasive Trichosporon asahii in patient blood by a fungal PCR array
Jasmin K Weber1, Sebastian Scharf1, Grit Walther2
1Institute for Medical Microbiology and Hospital Hygiene, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
Abstract:
Rare invasive fungal infections are increasingly emerging in hosts with predisposing factors such as immunodeficiency. Their timely diagnosis remains difficult, as their clinical picture may initially mimic infections with more common fungal species and species identification may be difficult with routine methods or may require time-consuming subcultures. This often results in ineffective drug administration and fatal outcomes. We report on a patient in their early twenties with mixed cellularity classical Hodgkin lymphoma with a disseminated Trichosporon asahii (T. asahii) infection. Even though pathogen detection and identification was possible via the standard procedure consisting of culture followed by matrix-assisted laser desorption ionisation-time of flight (MALDI-TOF) mass spectrometry, the patient passed away in the course of multi organ failure. Herein, we report on a retrospectively applied experimental diagnostic fungal PCR-analysis used on an EDTA blood sample and consisting of two pan-fungal reactions and seven branch-specific reactions. Regarding invasive T. asahii infection, this PCR array could considerably shorten time to diagnosis and switch to a targeted therapy with triazoles.
Insights
Diagnosing rare invasive fungal infections like Trichosporon asahii is challenging. A new fungal PCR array offers faster identification, potentially improving treatment outcomes for immunocompromised patients.
Area of Science:
- Mycology
- Medical Diagnostics
- Infectious Diseases
Background:
- Invasive fungal infections (IFIs) pose a significant threat to immunocompromised individuals.
- Timely diagnosis of IFIs is often hindered by non-specific clinical presentations and limitations of conventional identification methods.
- Delayed diagnosis can lead to ineffective treatments and poor patient outcomes.
Observation:
- A young adult with Hodgkin lymphoma developed a disseminated Trichosporon asahii infection.
- Standard diagnostic methods, including culture and MALDI-TOF, identified T. asahii, but the patient succumbed to multi-organ failure.
- A retrospectively applied experimental fungal PCR array on an EDTA blood sample was evaluated.
Findings:
- The experimental PCR array utilized two pan-fungal and seven species-specific reactions.
- This PCR array demonstrated the potential to significantly reduce the time required for diagnosing invasive T. asahii infections.
- The diagnostic approach could facilitate earlier targeted therapy with triazoles.
Implications:
- Faster and more accurate diagnosis of rare IFIs is crucial for effective patient management.
- The developed PCR array shows promise as a valuable tool for rapid identification of T. asahii.
- Advancements in molecular diagnostics can improve survival rates for patients with severe fungal infections.
