title: A case report of a cystic fibrosis patient with repeated isolation of Trichosporon mycotoxinivorans identified by a novel short-extraction method.
abstract: BACKGROUND
  Trichosporon mycotoxinivorans is a recently described yeast-like fungal organism and its association as a pathogen for patients with cystic fibrosis (CF) was reported previously. We show the clinical course of a CF patient over 9 years as well as the applications of modern molecular and proteomic identification techniques of this rare fungus.
  
  
  METHODS
  We present the case of a 32-year-old male CF patient with sputum cultures continuously positive with the anamorphic yeast T. mycotoxinivorans during 9 years. Furthermore, susceptibility testing of T. mycotoxinivorans to different antifungals were performed. In addition, a rapid identification method of this novel fungal pathogen with matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) was applied using a simple extraction protocol.
  
  
  CONCLUSIONS
  Our case presentation confirms T. mycotoxinivorans as a potential emerging pathogen in patients with CF. However, our CF patient showed mild symptoms over a very long time period of 9 years. A short MALDI-TOF MS procedure allows reliable and rapid identification of T. mycotoxinivorans and therefore should facilitate further study on the clinical relevance and epidemiology of this unusual fungal organism.
authors: Division of Clinical Microbiology, University Hospital Basel, Petersgraben 4, CH-4031, Basel, Switzerland. daniel.goldenberger@usb.ch.
authors: Daniel
authors: D
authors: Goldenberger
authors: Division of Clinical Microbiology, University Hospital Basel, Petersgraben 4, CH-4031, Basel, Switzerland.
authors: Vladimira
authors: V
authors: Hinić
authors: Division of Pathology, University Hospital Basel, Schönbeinstrasse 40, CH-4031, Basel, Switzerland.
authors: Spasenija Savic
authors: SS
authors: Prince
authors: Division of Pneumology, University Hospital Basel, Petersgraben 4, CH-4031, Basel, Switzerland.
authors: Michael
authors: M
authors: Tamm
authors: Division of Pneumology, University Hospital Basel, Petersgraben 4, CH-4031, Basel, Switzerland.|Present address: Division of Pneumology, St. Claraspital Basel, Basel, Switzerland.
authors: Anna-Maria
authors: AM
authors: Balestra
authors: Division of Clinical Microbiology, University Hospital Basel, Petersgraben 4, CH-4031, Basel, Switzerland.
authors: Doris
authors: D
authors: Hohler
authors: Division of Clinical Microbiology, University Hospital Basel, Petersgraben 4, CH-4031, Basel, Switzerland.
authors: Reno
authors: R
authors: Frei
mesh_terms: D000328:Adult; D000935:Antifungal Agents / Q000494:pharmacology; D003550:Cystic Fibrosis / Q000150:complications / Q000382:microbiology*; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D040901:Proteomics / Q000379:methods; D019032:Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization; D014250:Trichosporon / Q000187:drug effects / Q000302:isolation & purification* / Q000472:pathogenicity; D060586:Trichosporonosis / Q000188:drug therapy / Q000209:etiology / Q000382:microbiology
chemical_list: D000935:Antifungal Agents
keywords: Cystic fibrosis (CF); Emerging pathogen; Internal transcribed spacer (ITS); MALDI-TOF MS; Trichosporon mycotoxinivorans