Trichosporon fungaemia and disseminated, purpuric, papular skin lesions developed on the head, trunk and extremities of a 5-year-old female with acute lymphocytic leukaemia. Histopathologically, the skin lesions demonstrated dermal budding yeasts. She died despite treatment with antifungal drugs. The isolate from the blood was further identified morphologically and physiologically as Trichosporon asahii, based on the revision of the genus Trichosporon by Guého et al. (1992). According to the new revision, T. asahii is the only taxon regularly involved in systemic mycoses, so that most of the isolates previously reported as T. beigelii (formerly, T. cutaneum) in human deep mycoses are now thought to belong to T. asahii.

A 61-year-old man with pulmonary aspergilloma received two antifungals intracavitarily. Although clinical, serological and roentgenographic improvement were observed with fluconazole therapy, bronchial secretions continuously yielded Aspergillusfumigatus. Whenfluconazole was switched to amphotericin B, the pathogen was eradicated immediately. The minimal inhibitory concentrations (MICs) of the isolate were 400 jig/ml for fluconazole, and 0.2 jag/ml for amphotericin B. Although the discrepancy between in vitro and in vivo efficacy of antifungals has been argued, it was suggested the drug of choice should be selected on the basis of the MICresults at least in the intracavitary antifungal therapy for pulmonary aspergilloma. (Internal Medicine 34: 85-88, 1995)