Trichosporon inkin and Trichosporon mucoides as unusual causes of white piedra of scalp hair.

White piedra of scalp hair is considered a rare entity. We report three cases of this disorder all of whom presented with nodules on the hair. Potassium hydroxide preparations of the hair revealed clustered arthrospores and mature, easily detachable nodules. Cultures grew Trichosporon inkin in 2 patients and Trichosporon mucoides in one patient. Both these fungi are unusual causes of white piedra.

Fungemia due to Trichosporon mucoides in a diabetes mellitus patient: A rare case report.

Trichosporon species are widely distributed in nature and can occasionally belong to the human microbiota. For many years, Trichosporon beigelii, the only species of this genus, was found as the aetiological agent of superfi cial skin infection called white piedra. However, many cases of invasive trichosporonosis caused by different newly delineated species of Trichosporon have been published in increasing numbers in recent past years, especially in immunocompromised persons. We report a rare case of fungemia due to Trichosporon mucoides in a diabetes mellitus patient, which will add to the emerging list of trichosporonosis infections.

Oral colonization by yeasts in HIV-positive patients in Brazil / Colonização oral por leveduras em pacientes HIV-positivos no Brasil

INTRODUCTION: In HIV-infected patients, colonization of the oral cavity by potential pathogenic yeast may lead to development of systemic fungemia. We evaluated the prevalence of yeast in the oral cavity of Brazilian HIV-positive patients and verified whether or not the species characterized were enzymatically active. Furthermore, the species identified were tested for their susceptibility to antifungal treatment. METHODS: Patient saliva and oropharyngeal candidiasis samples were collected from 60 seropositive HIV patients and identified by the API20C system. Enzymatic activity was evaluated by the production of proteinase and phospholipase. Susceptibility to antifungal treatments were determined using the broth microdilution method. RESULTS: the most commonly isolated species were C. albicans (51.56 percent) followed by non-albicans Candida species (43.73 percent), Trichosporon mucoides (3.12 percent) and Kodamaea ohmeri (1.56 percent). Oral colonization by association of different species was observed in 42 percent of the patients. Enzymatic activity was verified in most of species isolated, except for C. glabrata, C. lusitaniae and C. guilliermondii. Resistance to Fluconazole and Amphotericin B was observed in isolates of C. albicans, C. glabrata, C. parapsilosis, C. krusei, and K. ohmeri. CONCLUSION: HIV-positive patients are orally colonized by single or multiple species of yeast that are occasionally resistant to Fluconazole or Amphotericin B.

INTRODUÇÃO: Em pacientes infectados pelo HIV, a colonização da cavidade bucal por leveduras patogênicas pode levar ao desenvolvimento de fungemias. No presente estudo, avaliamos a prevalência de leveduras na cavidade bucal de pacientes HIV-positivos e verificamos se as espécies isoladas foram enzimaticamente ativas. Além disso, as espécies identificadas foram testadas quanto à suscetibilidade a antifúngicos. MÉTODOS: Amostras de saliva e de candidose orofaríngea foram coletadas de 60 pacientes soropositivos para HIV e identificados pelo sistema API20C. A atividade enzimática foi avaliada pela produção de proteinase e fosfolipase. A suscetibilidade a antifúngicos foi determinada utilizando o método de microdiluição em caldo. RESULTADOS: As espécies mais comumente isoladas foram C. albicans (51,56 por cento), seguido por espécies de Candida não-albicans (43,73 por cento), Trichosporon mucoides (3,12 por cento) e Kodamaea ohmeri (1,56 por cento). A colonização bucal por associação de diferentes espécies foi observada em 42 por cento dos pacientes. A atividade enzimática foi verificada na maioria das espécies isoladas, com exceção de C. glabrata, C. lusitaniae e C. guilliermondii. Resistência ao fluconazol e anfotericina B foi observada em isolados de C. albicans, C. glabrata, C. parapsilosis, C. krusei, e K. ohmeri. CONCLUSÃO: Os pacientes HIV-positivos são colonizados por espécies únicas ou múltiplas de levedura que ocasionalmente são resistentes ao fluconazol ou anfotericina B.

Trichosporon mucoides infección en paciente inmunocompetente / Trichosporon mucoides infection in an immunocompetent host

Mujer de 40 a±os, con historia de un mes de evolución de necrosis progresiva del lecho ungueal del cuarto dedo de la mano derecha, con dolor intenso y destrucción de la placa ungueal. Sin antecedentes patológicos, ni traumßticos. En la biopsia se observaron estructuras micóticas y en los cultivos para hongos se obtuvo crecimiento de Trichosporon mucoides, confirmado mediante pruebas bioquímicas. Se inició fluconazol y se obtuvo resolución del cuadro. Estos hongos son habitantes normales del suelo y se caracterizan por la presencia de hifas verdaderas, pseudohifas, artroconidias y blastoconidas. T. mucoides puede comportarse como un patógeno oportunista que produce infecciones graves en huéspedes inmunocomprometidos. Se conocen casos aislados de T. mucoides como agente causal de onicomicosis pero ninguno con la severidad del caso que aquí se presenta.

A forty-year-old woman, hairdresser, presented a month history of progressive necrosis of the left fourth finger nailbed, accompanied by intense pain, without pathological antecedents and no trauma. Histologic examination showed extensive surface necrosis with abundant cell detritus and erythrocytes, within the necrotic tissue displacing the collagen. There were hyaline, birrefringent structures compatible with arthroconidia Tissue culture for aerobic as well as anaerobic bacteria and mycobacteria were negative. In tissue culture for fungus grew Trichosporon mucoides. A fluconazole therapy was initiated with 400 mg per week dosage, with clinical improvement. This fungus also normal soil inhabitant, is characterized by the presence of true hyphae, other members of the genus have pseudohyphae, arthroconidia y blastoconidia. T. mucoides can also be an opportunistic pathogen producing potentially fatal systemic infections in immunocompromised hosts. Cases of onychomycoses with this fungus as causative organism have been reported, but their symptomatology has not been as severe as in this case.