Disseminated Trichosporon beigelii (cutaneum) infection in an artificial heart recipient

A 44-year-old man with end-stage ischemic cardiomyopathy was supported with an intra-aortic balloon and The Penn State Heart (artificial) prior to orthotopic cardiac transplantation on the 14th hospital day. At the time of transplantation, intraoperative cultures of pericardial and mediastinal fluid showed growth of Trichosporon beigelii (cutaneum). Shortly thereafter the patient developed visceral dissemination of T beigelii with no associated skin lesions. He was treated with amphotericin B and rifampin, but postmortem examination showed persistent, disseminated infection.