Trichosporon Asahii Infection Mortality in Pediatric Oncology Patients: A Report of Six Cases

Abstract

The frequency of invasive fungal infections in patients with hematological malignancies has dramatically increased over the last two decades mainly due to increased use of more intensive therapies. Trichosporon spp is an uncommon but frequently fatal invasive yeast infection that occur predominantly in patients with hematological malignancies. Trichosporon Asahii (T. Asahii) is the most common genus isolated and is reported to cause serious invasive infections in adults and infrequently in children. Voriconazole (VCZ) remains the antifungal drug of choice. We report six pediatric patients with acute lymphoblastic leukemia (2), acute myeloblastic leukemia (2), lymphoblastic lymphoma (1) who developed invasive T. Asahii infection during the early phases of CTR. The outcome was poor. Five patients have died as a result of the infection after a stormy clinical course and prolonged stay in the pediatric intensive care unit despite receiving proper antifungal treatment. Only one patient survived the infection without serious sequalae.