Two Case Presentations Infected byTrichosporon asahiiand Treated with Voriconazole Successfully

Abstract

Background. Trichosporon asahii is an opportunistic fungus that causes infections in immunosuppressed patients. Neutropenia developing due to malignancies is an important risk factor for fungal infection. Case Report. We present two pediatric oncology cases successfully treated with voriconazole after T. asahii infection that is known to cause fatal sepsis and invasive fungal infection. Conclusion. There is no conclusive evidence that the antifungal agent voriconazole is effective in the neutropenic patients infected with Trichosporon asahii. Liposomal amphotericin B has also been reported to be inadequate for treatment. We believe that our patients were successfully treated and survived because the antifungal agents were started early and properly, although the infection can be fatal in up to 80% of cases despite treatment.

Invasive Trichosporon Infection: a Systematic Review on a Re-emerging Fungal Pathogen

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Disseminated Trichosporon asahii infection in a combined liver‐kidney transplant recipient successfully treated with voriconazole

“…The azole antifungals (fluconazole, voriconazole, posaconazole) have been shown to be effective against T. asahii. 7 Of these, voriconazole can be preferably used. 14,21,22 Newer antifungal isavuconazole also has activity against T. asahii and is a promising agent for these life threating infections.…”

“…Poor response and failure of therapy with amphotericin B and echinocandins have been reported. The azole antifungals (fluconazole, voriconazole, posaconazole) have been shown to be effective against T. asahii . Of these, voriconazole can be preferably used .…”

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

“…The number of cases reported have increased over the past decade, T sp. has become the second most common yeast genus causing fungemia in such patients after Candida sp [14][15][16].…”