Trichosporon asahii fungemia and COVID-19 co-infection: An emerging fungal pathogen; case report and review of the literature

Abstract

With the evolving COVID-19 pandemic, increasing concerns about invasive fungal infections have been reported particularly with the use of potent immunosuppressant medications to treat the immunological storms in patients with severe COVID-19 illnesses. Trichosporon asahii (T. asahii) is an emerging highly resistant pathogen with considerable mortality particularly in critically ill patients and immunocompromised individuals. We describe a case of a 58-year-old patient who developed T. asahii fungemia after using immunosuppressant agents for his severe COVID-19 related cytokines release syndrome. Pseudohyphae, arthroconidia, and lateral blastoconidia were seen in the stain, and later confirmed to be T. asahii. Voriconazole successfully treated this multi-drug-resistant fungal infection. The clinical presentation, assessment, and management are reviewed to raise awareness of the circumstances leading to coinfection with this emerging resistant yeast.

Detection of anti-Histoplasma capsulatum antibodies and seroconversion patterns in critically ill patients with COVID-19: An underdiagnosed fungal entity complicating COVID-19?

“…Those that have a fungal origin have become especially important and concerning during the COVID-19 pandemic, particularly invasive pulmonary aspergillosis (CAPA) and candidiasis, 7 although other fungal infections were described, including mucormycosis, 8 fusariosis 9 and trichosporinosis. 10 However, the relationship between COVID-19 and systemic endemic mycoses is less clear, with only a few published case reports of coccidiomycosis, histoplasmosis, and paracoccidioidomycosis in COVID-19 patients. 11–13 Particularly, all concomitant COVID-19 associated cases of histoplasmosis were reported among HIV/AIDS patients.…”

Fungal Bloodstream Co-infection by Trichosporon asahii in a COVID-19 Critical Patient: Case Report and Literature Review

“…and SARS-CoV-2 co-infection were described in the scientific literature until January 2022. Cases have been reported in different continents, including North America ( n = 1) [ 10 ], South America ( n = 6 cases including this report [ 4 ]), Europe ( n = 1) [ 6 ] and the Middle East ( n = 1) [ 9 ] (Fig. 4 ), presenting as nosocomial pneumonia [ 6 ], fungemia [ 4 , 9 ] or urinary tract infection [ 10 ].…”

“…Cases have been reported in different continents, including North America ( n = 1) [ 10 ], South America ( n = 6 cases including this report [ 4 ]), Europe ( n = 1) [ 6 ] and the Middle East ( n = 1) [ 9 ] (Fig. 4 ), presenting as nosocomial pneumonia [ 6 ], fungemia [ 4 , 9 ] or urinary tract infection [ 10 ]. All cases described were caused by Trichosporon asahii (Table 1 ) .…”

COVID-19-associated brain abscess caused by Trichosporon dohaense: A case report and review of literature

“…To date, 16 species of Trichosporon have been identified as potential human pathogens, of which T. asahii accounts for majority of the invasive infections [ 5 ]. So far, eight cases of invasive trichosporonosis (7 cases of fungemia and 1 case of pneumonia) have been reported in COVID-19 patients, all of which are attributed to T. asahii [ 6 , 7 ]. Here, we report the first case of COVID-19-associated brain abscess caused by a T. dohaense , a rare Trichosporon species that was not previously known to cause central nervous system (CNS) infection.…”