Disseminated trichosporonosis with atypical histologic findings in a patient with acute lymphocytic leukemia

Galligan, Eloise R.; Fix, Lindsey; Husain, Sameera; Zachariah, Philip; Yamashiro, Darrell J.; Lauren, Christine T.

doi:10.1111/cup.13397

Cited by 9 publications

(13 citation statements)

References 20 publications

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“…T. asahii infection is rare but often fatal. It commonly causes disseminated infections in immunocompromised patients 2,3 and results in death in 80 percent of affected patients 3 . Severely neutropenic oncology patients are especially vulnerable 3,4 .…”

Section: Discussionmentioning

confidence: 99%

“…Severely neutropenic oncology patients are especially vulnerable 3,4 . Skin manifestations vary, but usually present as purpuric, papulonodular or pustular lesions, and can have central necrosis 2 . Histopathology typically shows dermal fungal yeasts and hyphae, neutrophilic infiltrate, and occasional perivascular or vasculitic involvement 2 …”

Section: Discussionmentioning

confidence: 99%

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A rare case of cutaneous Trichosporon asahii infection in an immunocompromised child

Lee

Koh

2020

Pediatric Dermatology

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We present an 11-year-old girl who developed neutropenic fever and papulonodular lesions over her limbs and back following chemotherapy for relapsed acute myeloid leukemia. She was found to have cutaneous Trichosporon asahii infection, with no evidence of systemic infection, and responded to treatment with voriconazole. T. asahii infection is rare but often fatal and usually causes disseminated infections in immunocompromised patients. Cutaneous infection is relatively uncommon and rarely occurs in the pediatric population.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A rare case of cutaneous Trichosporon asahii infection in an immunocompromised child

Lee

Koh

2020

Pediatric Dermatology

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“…131 Recent studies have shown that the tendency for trichosporonosis to evade detection on blood culture and to resemble other better-known pathogens such as Candida on histology present additional diagnostic challenges. 241 It has been suggested that compared with Candida, Trichosporon has thinner hyphae and pseudohyphae, and stain slightly on Gomori methenamine silver (GMS) in comparison to other fungi. Nonetheless, histopathological detection of Trichosporon without immunohistochemistry, ELISA, and/or PCR confirmation is challenging.…”

Section: Trichosporonosismentioning

confidence: 99%

“…Although histological characteristics resembled neutrophilic eccrine hidradenitis but staining with periodic acid-Schiff stain (PAS) and GMS confirmed the clinical diagnosis. 241 Thus, trichosporonosis must be distinguished from candidiasis and other diseases, which share similar clinical and morphologic features in the disseminated form and their differences in treatment susceptibility.…”

Section: Trichosporonosismentioning

confidence: 99%

<p>An Overview of the Management of the Most Important Invasive Fungal Infections in Patients with Blood Malignancies</p>

Shariati¹,

Moradabadi²,

Chegini³

et al. 2020

IDR

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In patients with hematologic malignancies due to immune system disorders, especially persistent febrile neutropenia, invasive fungal infections (IFI) occur with high mortality. Aspergillosis, candidiasis, fusariosis, mucormycosis, cryptococcosis and trichosporonosis are the most important infections reported in patients with hematologic malignancies that undergo hematopoietic stem cell transplantation. These infections are caused by opportunistic fungal pathogens that do not cause severe issues in healthy individuals, but in patients with hematologic malignancies lead to disseminated infection with different clinical manifestations. Prophylaxis and creating a safe environment with proper filters and air pressure for patients to avoid contact with the pathogens in the surrounding environment can prevent IFI. Furthermore, due to the absence of specific symptoms in IFI, rapid and accurate diagnosis reduces the mortality rate of these infections and using molecular techniques along with standard mycological methods will improve the diagnosis of disseminated fungal infection in patients with hematologic disorders. Amphotericin B products, extended-spectrum azoles, and echinocandins are the essential drugs to control invasive fungal infections in patients with hematologic malignancies, and according to various conditions of patients, different results of treatment with these drugs have been reported in different studies. On the other hand, drug resistance in recent years has led to therapeutic failures and deaths in patients with blood malignancies, which indicates the need for antifungal susceptibility tests to use appropriate therapies. Life-threatening fungal infections have become more prevalent in patients with hematologic malignancies in recent years due to the emergence of new risk factors, new species, and increased drug resistance. Therefore, in this review, we discuss the different dimensions of the most critical invasive fungal infections in patients with hematologic malignancies and present a list of these infections with different clinical manifestations, treatment, and outcomes.

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“…This species is rarely involved in white piedra but is frequently recovered from patients with summer‐type hypersensitivity pneumonitis (SHP), an allergy developed after repeated inhalation of arthroconidia 8 . It is also isolated from immunocompromised patients and is the major Trichosporon species responsible for life‐threatening deep‐seated infection called trichosporonosis, 9‐13 mainly in patients with haematological malignancies 14‐16 . Fungaemia due to Trichosporon sp.…”

Section: Introductionmentioning

confidence: 99%

Epidemiological investigation for grouped cases of Trichosporon asahii using whole genome and IGS1 sequencing

Desnos‐Ollivier

Maufrais

Pihet

et al. 2020

Mycoses

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Summary Background Trichosporonosis is a rare invasive infection in humans mainly due to Trichosporon asahii, and especially recovered from patients having haematological malignancy. Since 2012, IGS1 region sequencing is used as a genotyping method to distinguish isolates, with high frequency of one haplotype worldwide and a geographic specificity for some haplotypes. Objectives We compared the IGS1 genotyping method and whole genome sequencing (WGS) to study the relationship between clinical isolates involved in two grouped cases in France. Methods IGS1 sequencing and antifungal susceptibility testing were performed for 54 clinical isolates. Clinical data for 28 isolates included in surveillance programs were analysed. Whole genome was sequenced for 32 clinical isolates and the type strain. Results All isolates were intrinsically resistant to flucytosine, while voriconazole had the most potent in vitro activity. The majority of the isolates was recovered from patients with haematological malignancies (42.86%), with a high proportion of children (<15 yrs‐old, 32.14%) and a high mortality rate at three months (46.15%). Based on the WGS analysis, isolates exhibiting IGS1 haplotype 1, 3 and 7 belonged to different clades. Five isolates recovered during the first grouped cases had the same IGS1 haplotype and shared 99% of SNPs similarity. For the second grouped cases, four isolates had 98.7% of SNPs similarity while the isolate recovered 4 years earlier was totally unlinked. Conclusions We confirmed the usefulness of IGS1 sequencing for grouped cases infection of T. asahii. We underlined its limitation for the study of population structure and the utility of WGS analysis for the study of epidemiologically unrelated isolates.

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Disseminated trichosporonosis with atypical histologic findings in a patient with acute lymphocytic leukemia

Cited by 9 publications

References 20 publications

A rare case of cutaneous Trichosporon asahii infection in an immunocompromised child

A rare case of cutaneous Trichosporon asahii infection in an immunocompromised child

<p>An Overview of the Management of the Most Important Invasive Fungal Infections in Patients with Blood Malignancies</p>

Epidemiological investigation for grouped cases of Trichosporon asahii using whole genome and IGS1 sequencing

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