title: Invasive Trichosporon cutaneum infection: an increasing problem in immunosuppressed patients.
abstract: Trichosporon cutaneum (syn. T. beigelii), a saprophytic fungal organism normally found in the soil, is increasingly being recognized as a cause of life-threatening systemic illness in immunosuppressed patients. Of 42 cases reported in the literature, 27 (64%) have died, including all four occurring after bone marrow transplantation. We report here a 44-year-old man who developed an invasive pulmonary infection and fungemia with T. cutaneum following bone marrow transplantation. The infection was manifest by severe respiratory distress and hypoxemia despite a clear chest X-ray, and was diagnosed by the identification of fungal hyphae on a percutaneous lung aspirate and by culture of the organism from the blood. Despite the previous reports indicating that there is a high mortality rate in this situation, the patient recovered following treatment with amphotericin B, miconazole and ketoconazole. T. cutaneum needs to be recognized as a potentially serious but treatable pathogen in severely immunosuppressed patients, including bone marrow transplant recipients.
authors.affiliation: Department of Medicine, University of Tasmania, Hobart, Australia.
authors.forename: R M
authors.initials: RM
authors.lastname: Lowenthal
authors.forename: K
authors.initials: K
authors.lastname: Atkinson
authors.forename: D R
authors.initials: DR
authors.lastname: Challis
authors.forename: R G
authors.initials: RG
authors.lastname: Tucker
authors.forename: J C
authors.initials: JC
authors.lastname: Biggs
mesh_terms: D000328:Adult; D016026:Bone Marrow Transplantation; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects*; D015470:Leukemia, Myeloid, Acute / Q000628:therapy; D008297:Male; D009181:Mycoses / Q000209:etiology* / Q000628:therapy; D009894:Opportunistic Infections / Q000209:etiology* / Q000628:therapy; D014250:Trichosporon