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.

White piedra: molecular identification of Trichosporon inkin in members of the same family / Piedra branca: identificação molecular do Trichosporon inkin em membros de mesma família

INTRODUCTION: White piedra is a superficial mycosis caused by the genus Trichosporon and characterized by nodules on hair shaft. METHODS: The authors report a family referred to as pediculosis. Mycological culture on Mycosel® plus molecular identification was performed to precisely identify the etiology. RESULTS: A Trichosporon spp. infection was revealed. The molecular procedure identified the agent as Trichosporon inkin. CONCLUSIONS: White piedra and infection caused by T. inkin are rarely reported in Southern Brazil. The molecular tools are essentials on identifying the Trichosporon species.

INTRODUÇÃO: Piedra branca é micose superficial causada por fungos do gênero Trichosporon e caracterizado por nódulos firmemente aderidos à haste do pêlo. MÉTODOS: Os autores relatam casos familiares encaminhados como pediculose. Foram utilizados cultura em ágar Mycosel® e identificação molecular. RESULTADOS: Exame micológico revelou a infecção por Trichosporon spp. A identificação molecular demonstrou se tratar do Trichosporon inkin. CONCLUSÕES: Piedra branca e infecção pelo T. inkin são raramente relatados na região sudeste do Brasil. A identificação molecular é essencial para correta determinação de espécies no gênero Trichosporon.

A Case of Trichosporon inkin Continuous Ambulatory Peritoneal Dialysis Peritonitis Identified by 18S rRNA Sequencing / 대한신장학회지

Fungal peritonitis in peritoneal dialysis patients is hard to treat without catheter removal and shows higher mortality. Although Candida species is the most common pathogen of fungal peritonitis, there are few reports about Trichosporon inkin induced peritonitis. The authors report the first case of Trichosporon induced peritonitis identified by 18S rRNA sequencing. A 52-year-old male presented to emergency room due to generalized abdominal pain. He had been on continuous ambulatory peritoneal dialysis for 3 years because of end stage renal disease caused by diabetic kidney disease. Dialysate white blood cell count was 800/mL3 with 77% of neutrophils and culture showed Trichosporon inkin via Vitek II system. With removal of catheter and treatment of antifungal agent, the patient was fully recovered and stable on hemodialysis. In case of immunocompromised dialysis patients, uncommon fungal pathogens should be taken into considerations.

Piedra blanca genital / Genital white piedra

ANTECEDENTES: la piedra blanca es una micosis caracterizada por la presencia de nódulos de color blanco a pardo claro, adheridos a los pelos de la región genital, axilas, cejas, pestañas y cuero cabelludo, es causada principalmente por Trichosporon inkin y Trichosporon ovoides. PRESENTACIÓN DEL CASO: paciente del sexo femenino de 35 años, originaria de San Pedro Sula, Honduras, de buena presencia física y buenos hábitos higiénicos, acude a consulta por presentar nódulos en los pelos púbicos, asintomáticos, de 2 meses de evolución. Al examen físico se pudo observar la presencia de nódulos de color blanquecino a pardo claro, blandos, de 1 a 2 mm, que rodeaban los pelos. No se detectó fluorescencia de los pelos a la luz de Wood. Al examen microscópico se observaron blastoconidios y artroconidios; en el cultivo se obtuvo el crecimiento de colonias levaduriformes, elevadas, de aspecto cerebriforme; en el microcultivo en agar extracto de malta se observaron hifas hialinas, tabicadas que formaban apresorios, pseudohifas fragmentadas, artroconidios rectangulares y blastoconidios. Mediante el sistema API ID32C fue identificado como Trichosporon inkin. Se instauró tratamiento con crema de isoconazol, previo rasurado del vello púbico. Los exámenes realizados al final del tratamiento fueron negativos. CONCLUSIONES: se presenta un caso de piedra blanca genital en el sexo femenino y se hace una actualización sobre la taxonomía del género Trichosporon sobre la base de los estudios moleculares, se discute el papel de T. inkin en esta micosis y su relevancia creciente como agente de infecciones invasivas en pacientes inmunocomprometidos, así como la importancia del diagnóstico de laboratorio para la confirmación de los casos.

INTRODUCTION: white piedra is a type of mycosis characterized by white to light brown nodules attached the hair shafts of genitals, axilla, eyelashes, eyebrowns, and scalp and is mainly caused by Trichosporon inkin and Trichosporon ovoides. CASE PRESENTATION: a 35 years-old female with good physical condition and good hygienic habits, who came from San Pedro Sula in Honduras, went to the doctor because of some nodules in their genital hair, asymptomatic, two months of evolution. On physical examination, it was observed that there were white-to-light brown coloured nodules measuring 1-2mm and surrounding the hair shafts. No fluorescence was detected in the hair on Wood´s light. On microscopic examination, blastoconidia and arthroconidia were observed; the culture yielded the growth of elevated yeastlike colonies; the microculture in malt extract agar showed disarticulating hyaline hyphae, partitioned appressoria, fragmented pseudohyphae, rectangular arthroconidia and blastoconidia. Through the API ID32C system, it was identified as Trichosporon inkin. The patient was treated with Isoconazole cream after her genital hair had been shaved. At the end of treatment, the exam results were negative. CONCLUSIONS: the case of a female with genital white piedra was presented and an updating on Trichosporon genus taxonomy on the basis of molecular studies. The role of T. inkin in this mycosis, and its growing importance as an agent of invasive infections in immunocompromised patients, as well as the relevance of lab diagnosis to confirm cases, were discussed.

Profile of susceptibility in vitro of Trichosporon asahii and Trichosporon inkin strains against cyclic imides

In vitro susceptibility testing of Trichosporon asahii (13 strains) and T. inkin (13 strains) against cyclic imides (succinimides, naphtalimides and maleimides) in concentrations of 200 to 6,25 μg/mL was performed according to the diffusion agar method. By the results obtained, the antifungal activity of the cyclic imides: 3,4-dichloro-N-phenyl-maleimide; 3,4-dichloro-N-phenyl-ethyl-maleimide and 3,4-dichloro-N-phenyl-propyl-maleimide (50 μg/mL) over T. asahii and T. inkin was important and it may be helpful in showing perspectives in a search for new antimicotic products.

O perfil de sensibilidade in vitro de Trichosporon asahii (13 cepas) e T. inkin (13 cepas) frente a imidas cíclicas (naftalimidas, succinimidas e maleimidas) nas concentrações de 6,25 a 200 μg/mL foi realizado pelo método de difusão em agar. Pelos resultados obtidos, a atividade antifúngica das imidas cíclicas: 3,4-dicloro-N-fenil-maleimida; 3,4-dicloro-N-fenil-etil-maleimida e 3,4-dicloro-N-fenil-propil-maleimida (50 μg/mL) sobre T. asahii e T. inkin foi importante e pode abrir perspectivas na busca de novos produtos antimicóticos.