Invasive Trichosporon cutaneum infection: an increasing problem in immunosuppressed patients.
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.
Lowenthal
R M
RM
Department of Medicine, University of Tasmania, Hobart, Australia.
Atkinson
K
K
Challis
D R
DR
Tucker
R G
RG
Biggs
J C
JC
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