title: The usefulness of magnetic resonance imaging (MRI) for disseminated trichosporosis of the gastrocnemius muscles.
abstract: A 30-year-old man with acute myeloid leukemia who was pancytopenic after undergoing intensive chemotherapy developed pyrexia and severe pain of both lower legs. We immediately started empiric therapy with cefepime, vancomycin, and fluconazole for febrile neutropenia. However, symptoms progressed. After 4 days, Trichosporon was isolated from venous blood cultures. MRI showed hyperintense lesions within both gastrocnemius muscles and demonstrated reactive vasodilatation and interstitial tissue edema, thought to be induced by hyperpermeability of vessel membranes due to the local fungal infection. Amphotericin B was very effective against this organism. Trichosporosis is a rare infectious disease generally occurring in immunocompromized hosts. To the best of our knowledge, this is first reported case of bilateral Trichosporon infection of lower leg muscles. Severe leg pain was one of the most important signs of fungal infection in this patient with hematologic malignancy.
authors.affiliation: Division of Hematology, Department of Medicine, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi 329-0498, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Meguro-Hashimoto
authors.forename: Masaaki
authors.initials: M
authors.lastname: Takatoku
authors.forename: Ken
authors.initials: K
authors.lastname: Ohmine
authors.forename: Masaki
authors.initials: M
authors.lastname: Toshima
authors.forename: Masaki
authors.initials: M
authors.lastname: Mori
authors.forename: Tadashi
authors.initials: T
authors.lastname: Nagai
authors.forename: Kazuo
authors.initials: K
authors.lastname: Muroi
authors.forename: Keiya
authors.initials: K
authors.lastname: Ozawa
mesh_terms: D000328:Adult; D000666:Amphotericin B / Q000627:therapeutic use; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D018482:Muscle, Skeletal / Q000382:microbiology* / Q000473:pathology; D009135:Muscular Diseases / Q000188:drug therapy / Q000382:microbiology* / Q000473:pathology; D009181:Mycoses / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D014250:Trichosporon / Q000302:isolation & purification*
chemical_list: D000666:Amphotericin B