Infect Chemother.  2018 Jun;50(2):138-143. 10.3947/ic.2018.50.2.138.

Catheter-Related Trichosporon asahii Bloodstream Infection in a Neutropenic Patient with Myelodysplastic Syndrome

Affiliations
  • 1Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
  • 2Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea. mdcjk@catholic.ac.kr
  • 3Vaccine Bio Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea.
  • 4Catholic Hematology Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.

Abstract

Because primary antifungal prophylaxis is widely used for immunocompromised hosts, the incidences of unusual fungal infections have increased. Trichosporon asahii has emerged as an important life-threatening opportunistic systemic pathogen because of the increased use of cytotoxic or immunosuppressant agents, along with high mortality rates. Here, we describe a case of catheter-related T. asahii bloodstream infection with multiple septic skin nodules in both the arms and legs of the patient who was in the neutropenic period after allogeneic stem cell transplantation for myelodysplastic syndrome treated with prophylactic ciprofloxacin and itraconazole. We successfully treated her with intravenous voriconazole for more than a month without any complications. Clinicians should consider breakthrough Trichosporon infections when clinical progress in an immunocompromised patient with unexplained infection signs and symptoms does not improve despite proper treatment with antibiotics or various antifungal agents. In addition, voriconazole can be a good treatment choice for achieving better treatment results and prognosis.

Keyword

Trichosporon asahii; Catheter-related infection; Fungemia; Voriconazole; Stem cell transplantation

MeSH Terms

Anti-Bacterial Agents
Antifungal Agents
Arm
Catheter-Related Infections
Ciprofloxacin
Fungemia
Humans
Immunocompromised Host
Incidence
Itraconazole
Leg
Mortality
Myelodysplastic Syndromes*
Prognosis
Skin
Stem Cell Transplantation
Trichosporon*
Voriconazole
Anti-Bacterial Agents
Antifungal Agents
Ciprofloxacin
Itraconazole
Voriconazole
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