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[Cutaneous manifestations during disseminated trichosporonosis in an AIDS patient]
A S Lascaux1, F Bouscarat, V Descamps
1Service de Dermatologie, Hôpital Bichat, Paris.
Background:
Trichosporon beigelii, causal agent of white piedra can cause disseminated infection in immunodepressed subjects. Systemic infections due to this pathogen have been reported mainly in neutropenic patients and rarely in AIDS patients.
Case Report:
A 36-year-old HIV+ man from Senegal was hospitalized for fever and meningoencephalitis associated with skin lesions. T. beigelii was isolated from skin biopsies and cerebrospinal fluid cultures. The patients was treated with amphotericin B with regression of the skin lesions. The diagnosis of disseminated T. beigelii infection was retained.
Discussion:
Disseminated T. beigelii infections are known to occur in immunodepressed subjects, especially in case of neutropenia. In our patient, the presence of two proven localizations (meninges and skin) and the favorable outcome with amphotericin B favored disseminated infection. The good response to treatment can probably be explained by the absence of neutropenia. Skin lesions are frequent, usually occurring as disseminated papulae or purpural nodules. Pathology examination and skin biopsy culture can provide rapid diagnosis allowing appropriate treatment.
Insights
Disseminated Trichosporon beigelii infection, a rare fungal disease, can affect immunocompromised individuals. Early diagnosis and treatment with amphotericin B are crucial for favorable outcomes, even in HIV patients without neutropenia.
Area of Science:
- Mycology
- Infectious Diseases
- Clinical Medicine
Background:
- Trichosporon beigelii, the cause of white piedra, can lead to disseminated infections, particularly in immunocompromised individuals.
- Systemic infections are predominantly observed in neutropenic patients and less frequently in those with Acquired Immunodeficiency Syndrome (AIDS).
Observation:
- A 36-year-old HIV-positive male presented with fever, meningoencephalitis, and skin lesions.
- Trichosporon beigelii was identified in skin biopsies and cerebrospinal fluid, confirming disseminated infection.
Findings:
- The patient received amphotericin B, resulting in the regression of skin lesions.
- The absence of neutropenia in this patient likely contributed to the favorable response to antifungal therapy.
Implications:
- Disseminated T. beigelii infections necessitate prompt diagnosis and treatment, even in non-neutropenic HIV patients.
- Skin biopsies and cultures are vital for rapid diagnosis and guiding appropriate antifungal strategies.
- This case highlights the importance of considering disseminated fungal infections in immunocompromised patients presenting with systemic symptoms and skin manifestations.