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1.
Rev. chil. infectol ; 40(3): 308-312, jun. 2023. ilus
Article Dans Espagnol | LILACS | ID: biblio-1515122

Résumé

La enfermedad fúngica invasora (EFI) es una de las principales causas de morbimortalidad en los pacientes pediátricos inmunocom- prometidos. Los hongos que con mayor frecuencia causan EFI en este grupo de pacientes corresponden a especies de Candida y Aspergillus. Sin embargo, en los últimos años se ha descrito un aumento de patógenos no clásicos, tales como Fusarium, Scedosporium, Mucorales, Cryptococcus, Trichosporon, entre otros. Se presenta un caso de EFI por Trichosporon asahii en un preescolar con una leucemia linfo- blástica aguda en quimioterapia de inducción. Además, se presenta una revisión actualizada de la literatura especializada, con énfasis en la importancia del diagnóstico precoz y el tratamiento antifúngico específico.


Invasive fungal disease (IFD) is one of the leading causes of morbidity and death among immunosuppressed pediatric patients. The fungi that most frequently cause IFD in this group of patients correspond to Candida and Aspergillus species, however, in recent years an increase in non-classical pathogens, such as Fusarium, Scedosporium, Mucorales, Cryptococcus, Trichosporon, among others. A case of invasive fungal disease caused by Trichosporon asahii is presented in a preschool patient with acute lymphoblastic leukemia in induction stage. This review highlights the importance of active search for pathogens in immunosuppressed patients, and proposes a specific treatment.


Sujets)
Humains , Mâle , Enfant d'âge préscolaire , Leucémie-lymphome lymphoblastique à précurseurs B et T/complications , Trichosporonose/complications , Infections fongiques invasives , Trichosporon/isolement et purification , Trichosporonose/diagnostic , Trichosporonose/microbiologie , Trichosporonose/traitement médicamenteux , Antifongiques/usage thérapeutique
2.
An. bras. dermatol ; 96(5): 595-597, Sept.-Oct. 2021. graf
Article Dans Anglais | LILACS | ID: biblio-1345137

Résumé

Abstract Trichosporon asahii is the causal agent of trichosporonosis. Patients with immunosuppression or hematological malignancies are at higher risk of infection. Skin and mucosal involvement appear as fast-growing papulonodular lesions and necrotic ulcers. Internal organ dissemination is lethal. Therapeutic success depends on the underlying disease. Here, the authors present the first case of disseminated mucocutaneous trichosporonosis in a patient with a post-mortem diagnosis of histiocytic sarcoma, a rare and aggressive haematolymphoid neoplasm. Regretfully, death occurred despite treatment with liposomal amphotericin B and supportive measures, showcasing the fatality of both diseases.


Sujets)
Humains , Trichosporon , Sarcome histiocytaire/traitement médicamenteux , Trichosporonose/diagnostic , Trichosporonose/traitement médicamenteux , Basidiomycota , Antifongiques/usage thérapeutique
3.
Arch. argent. pediatr ; 115(5): 311-314, oct. 2017. ilus
Article Dans Espagnol | LILACS, BINACIS | ID: biblio-887384

Résumé

Trichosporon asahii es un hongo ubicuo que se ha aislado como parte de la microbiota humana. Recientemente, se ha visto una emergencia de este patógeno en infecciones tanto localizadas como sistémicas. En unidades de cuidados intensivos pediátricos para quemados, existen escasos reportes de infecciones del tracto urinario por este microorganismo. Se describen 2 pacientes pediátricos con internación prolongada por quemaduras extensas y múltiples tratamientos antibióticos previos. Ambos presentaron sepsis por infección del tracto urinario asociada a sonda vesical por Trichosporon asahii. En ambos pacientes, se realizó el recambio de la sonda vesical y tratamiento con voriconazol por 10 días, con buena evolución. En los casos presentados, debido a la ausencia de otros aislamientos microbiológicos y a la buena respuesta al tratamiento antifúngico junto con el recambio de la sonda vesical, se asumió al Trichosporon asahii como el probable agente causal de la sepsis.


Trichosporon asahii is a ubiquitous fungus that has been isolated as part of human microbiota. There has been an emergence of this pathogen in recent years, causing superficial and deep seated infections. There are scarce reports of urinary tract infections in pediatric intensive care burn units caused by this agent. We describe the cases of 2 pediatric patients with prolonged hospitalization due to severe burns that had received several antibiotic courses for previous infections. Both presented sepsis secondary to catheter related urinary tract infection by Trichosporon asahii. Both patients underwent urinary catheter replacement and were treated effectively with voriconazole for 10 days. In the cases presented, sepsis was assumed to be due to Trichosporon asahii since no other microorganism was identified and the patients showed favorable outcome with the prescribed treatment with voriconazole and replacement of the urinary catheter.


Sujets)
Humains , Mâle , Enfant d'âge préscolaire , Infections urinaires/étiologie , Sepsie/étiologie , Infections sur cathéters/étiologie , Trichosporonose/étiologie , Cathéters urinaires/effets indésirables , Unités de soins intensifs de brûlés , Brûlures/complications
4.
Mem. Inst. Oswaldo Cruz ; 112(10): 719-722, Oct. 2017. graf
Article Dans Anglais | LILACS | ID: biblio-1040562

Résumé

We report the first two cases of Trichosporon mycotoxinivorans infections in Latin America. We also conducted a literature review and a microbiological investigation, including that of clinical and environmental isolates. A 30-year-old man with chronic renal failure had disseminated infection after dialysis and a 15-year-old boy with cystic fibrosis (CF) had pulmonary exacerbations with positive respiratory samples. A review of the relevant literature revealed that deep-seated infections were related to immunosuppression or invasive devices, while most of the CF patients showed a decline in lung function after positive cultures. Phylogenetic analyses revealed three distinct circulating genotypes. MALDI-TOF mass spectrometry analysis showed similar spectral profiles and correctly identified all strains/isolates. Biofilm production was documented in a bloodstream isolate and biofilm-producing cells showed high minimum inhibitory concentrations against antifungals.


Sujets)
Humains , Mâle , Adolescent , Adulte , Trichosporon/génétique , Trichosporonose/diagnostic , Trichosporon/classification , Trichosporon/effets des médicaments et des substances chimiques , Brésil/épidémiologie , Tests de sensibilité microbienne , Biofilms/croissance et développement , Trichosporonose/microbiologie , Trichosporonose/épidémiologie , Génotype , Amérique latine , Antifongiques/pharmacologie
5.
Rev. argent. microbiol ; 48(1): 62-66, mar. 2016. graf.
Article Dans Anglais | LILACS | ID: biblio-1284344

Résumé

En este estudio fueron analizadas mediante el cultivo muestras de orina de pacientes hospitalizados en la región centro-oeste de Brasil; los microorganismos aislados fueron identificados filogenéticamente como Trichosporon asahii. A través del análisis de máxima parsimonia de las secuencias de IGS1, fueron encontrados 3 genotipos que no habían sido descritos anteriormente. Las concentraciones inhibitorias mínimas frente a los 9 aislados identificados presentaron un rango de 0,06-1µg/ml en el caso de la anfotericina B, de 0,25-4µg/ml en el del fluconazol, y de 0,03-0,06µg/ml en el del itraconazol. Aproximadamente 6/9 de los aislados de T. asahii formaron biopelículas en la superficie de microplacas de poliestireno. Este trabajo documenta el aislamiento de T. asahii como agente causal de infeciones urinarias nosocomiales. Además, demuestra que la región IGS1 puede ser considerada una nueva herramienta epidemiológica para la genotipificación de los aislados de T. asahii. Los genotipos menos comunes encontrados en este estudio pueden estar relacionados con las características epidemiológicas locales


In this study, the culture analysis of urine samples from patients hospitalized in the Central-West region of Brazil was performed, and the isolated microorganisms were phylogenetically identified as Trichosporon asahii. Maximum parsimony analysis of the IGS1 sequences revealed three novel genotypes that have not been described. The minimum inhibitory concentrations of the nine isolates identified were in the range of 0.06­1µg/ml for amphotericin B, 0.25­4µg/ml for fluconazole, and 0.03­0.06µg/ml for itraconazole. Approximately 6/9 of the T. asahii isolates could form biofilms on the surface of polystyrene microplates. This study reports that the microorganisms isolated here as T. asahii are agents of nosocomial urinary tract infections. Furthermore, the IGS1 region can be considered a new epidemiological tool for genotyping T. asahii isolates. The least common genotypes reported in this study can be related to local epidemiological trends


Sujets)
Humains , Mâle , Femelle , Infections urinaires/microbiologie , Trichosporon/isolement et purification , Trichosporon/classification , Tests de sensibilité microbienne/méthodes , Urine/microbiologie , Trichosporonose/épidémiologie , Profil génétique
6.
Braz. j. infect. dis ; 19(5): 549-552, tab
Article Dans Anglais | LILACS | ID: lil-764502

Résumé

ABSTRACTEmpirical antifungal therapy is most often given to patients with leukemia. However breakthrough fungal infections under antifungal therapy are not uncommon. Four children, with hematologic malignant disease developed mycotic breakthrough infections while on empirical caspofungin treatment for a median of 14 (range 11-19) days. Trichosporon asahii was detected in the blood culture of two patients and Geotrichum capitatum in the other two (one patient also had positive cerebrospinal fluid culture). Because the patients' clinical situation worsened, voriconazole was empirically added for two patients three and five days before the agent was detected. The first sterile blood culture was obtained 3-7 days of voriconazole treatment. All patients reached clear cultures but one patient died. One patient with central nervous system infection with G. capitatum had severe neurological sequelae. Very severe fungal infections can occur during empirical caspofungin therapy. Therefore, patients should be followed closely.


Sujets)
Adolescent , Enfant , Enfant d'âge préscolaire , Femelle , Humains , Mâle , Antifongiques/usage thérapeutique , Échinocandines/usage thérapeutique , Neutropénie fébrile/traitement médicamenteux , Géotrichose/diagnostic , Mycoses/diagnostic , Trichosporonose/diagnostic , Neutropénie fébrile/microbiologie , Géotrichose/microbiologie , Mycoses/microbiologie , Maladies rares , Indice de gravité de la maladie , Trichosporonose/microbiologie
7.
Rev. bras. ter. intensiva ; 27(3): 247-251, jul.-set. 2015. tab
Article Dans Portugais | LILACS | ID: lil-761674

Résumé

RESUMOObjetivo:Avaliar a incidência de infecções do trato urinário por Trichosporon spp. em uma unidade de terapia intensiva.Métodos:Estudo descritivo observacional realizado em uma unidade de terapia intensiva no período de 2007 a 2009. Foram analisados todos os pacientes consecutivos que internaram na unidade de terapia intensiva e tiveram o diagnóstico confirmado.Resultados:Vinte pacientes apresentaram infecções do trato urinário por Trichosporon spp. A prevalência foi maior no sexo masculino (65%) e na faixa etária superior a 70 anos (55%). A mortalidade foi de 20%. A média de permanência na unidade de terapia intensiva foi de 19,8 dias. Seu aparecimento esteve relacionado ao uso pregresso de antibióticos e foi mais frequente no período que compreendeu o outono e o inverno.Conclusão:A infecção por Trichosporon spp. predominou no sexo masculino, de idade acima de 70 anos, com uso de sonda vesical de demora por mais de 20 dias e com uso de antibióticos de amplo espectro acima de 14 dias. Os pacientes que apresentaram a infecção urinária por Trichosporon spp. ficaram internados nos setores de terapia intensiva, com maior frequência, no período de outono e inverno.


ABSTRACTObjective:To evaluate the incidence of urinary tract infections due to Trichosporon spp. in an intensive care unit.Methods:This descriptive observational study was conducted in an intensive care unit between 2007 and 2009. All consecutive patients admitted to the intensive care unit with a confirmed diagnosis were evaluated.Results:Twenty patients presented with urinary tract infections due to Trichosporon spp. The prevalence was higher among men (65%) and among individuals > 70 years of age (55%). The mortality rate was 20%. The average intensive care unit stay was 19.8 days. The onset of infection was associated with prior use of antibiotics and was more frequent in the fall and winter.Conclusion:Infection due to Trichosporon spp. was more common in men and among those > 70 years of age and was associated with the use of an indwelling urinary catheter for more than 20 days and with the use of broadspectrum antibiotics for more than 14 days. In addition, patients with urinary infection due to Trichosporon spp. were most often hospitalized in intensive care units in the fall and winter periods.


Sujets)
Adulte , Sujet âgé , Femelle , Humains , Mâle , Adulte d'âge moyen , Unités de soins intensifs , Trichosporon/isolement et purification , Trichosporonose/épidémiologie , Infections urinaires/épidémiologie , Facteurs âges , Antibactériens/administration et posologie , Études de cohortes , Incidence , Durée du séjour , Prévalence , Études rétrospectives , Facteurs de risque , Saisons , Facteurs sexuels , Trichosporonose/microbiologie , Infections urinaires/microbiologie
8.
Arq. bras. oftalmol ; 78(4): 252-254, July-Aug. 2015. ilus
Article Dans Anglais | LILACS | ID: lil-759251

Résumé

ABSTRACTPostoperative fungal endophthalmitis is a rare but devastating complication of cataract surgery. Vitrectomy and intravitreal amphotericin B injection as well as administration of systemic antifungal agents have been suggested as optimal treatments for fungal endophthalmitis. However, this therapy may fail to eliminate fungal species resistant to current antifungal agents. The saprophytic fungus Trichosporon asahii is frequently observed as a cause of endogenous endophthalmitis in immunosuppressed patients. We report a case of postoperative endophthalmitis caused by T. asahii, resistant to amphotericin B. To the best of our knowledge, this is the first report of T. asahii endophthalmitis successfully treated with intravitreal and systemic voriconazole, pars plana vitrectomy, and removal of the intraocular lens and entire lens capsule.


RESUMOEndoftalmite fúngica pós-operatória é uma complicação rara mas devastadora da cirurgia de catarata. A vitrectomia e injeção intravítrea de anfotericina B, bem como agentes fungicidas sistêmicos, têm sido sugeridos como tratamentos ideais para endoftalmite fúngica. No entanto, esta terapia pode falhar em erradicar as espécies de fungos resistentes aos agentes antifúngicos atuais. Uma dessas espécies de fungos é o fungo saprófita,Trichosporon asahii, que é frequentemente observada, como causa de endoftalmite endógena, em pacientes imunodeprimidos. Relatamos um caso de endoftalmite pós-operatória causada porT. asahii que é resistente a anfotericina B. Ao nosso conhecimento, este é o primeiro relato de endoftalmite porT. asahii tratado com sucesso com voriconazol intravítreo e sistêmico, vitrectomia viapars plana, e remoção da lente intraocular e saco capsular.


Sujets)
Sujet âgé , Humains , Mâle , Antifongiques/administration et posologie , Extraction de cataracte/effets indésirables , Endophtalmie/traitement médicamenteux , Mycoses oculaires/traitement médicamenteux , Trichosporonose/traitement médicamenteux , Voriconazole/administration et posologie , Endophtalmie/microbiologie , Mycoses oculaires/microbiologie , Injections intravitréennes , Trichosporon/classification , Trichosporon/isolement et purification
9.
Annals of Clinical Microbiology ; : 56-59, 2015.
Article Dans Coréen | WPRIM | ID: wpr-23351

Résumé

Since the report of disseminated trichosporonosis in 1970s, several cases of infection by various Trichosporon species in different clinical patients were published. We've isolated a strain of T. asahii from not only blood but also urine. We report 71 year-old male patient with Trichosporon asahii fungemia, who had renal stones. It was identified as T. asahii using conventional method and also confirmed by 18S rRNA gene sequencing. The patient was discharged without any complication, in which case only antibiotic agent was used without any antifungal one.


Sujets)
Humains , Mâle , Fongémie , Gènes d'ARN ribosomique , Trichosporon , Trichosporonose , Infections urinaires
10.
Indian J Med Microbiol ; 2012 Apr-June; 30(2): 229-232
Article Dans Anglais | IMSEAR | ID: sea-143953

Résumé

The aetiology of fungal sinusitis is diverse and changing. Aspergillus species has been the most common cause for fungal sinusitis, especially in dry and hot regions like India. Trichosporon species as a cause for fungal sinusitis has been very rarely reported the world over. Here, we report a rare case of allergic fungal sinusitis caused by Trichosporon inkin in a 28-year-old immunocompetent woman. Bilateral nasal obstruction, nasal discharge and loss of smell were her presenting complaints. Diagnostic nasal endoscopy showed bilateral multiple polyps. Functional endoscopic sinus surgery was performed and many polyps were removed. Based on mycological and histopathological studies, the pathogen was identified as T. inkin.


Sujets)
Adulte , Endoscopie , Femelle , Histocytochimie , Humains , Hypersensibilité/diagnostic , Hypersensibilité/anatomopathologie , Inde , Fosse nasale/anatomopathologie , Polypes/complications , Polypes/diagnostic , Polypes/chirurgie , Sinusite/diagnostic , Sinusite/microbiologie , Sinusite/anatomopathologie , Trichosporon/isolement et purification , Trichosporonose/diagnostic , Trichosporonose/microbiologie , Trichosporonose/anatomopathologie
11.
Rev. Inst. Med. Trop. Säo Paulo ; 54(1): 1-3, Jan.-Feb. 2012.
Article Dans Anglais | LILACS | ID: lil-614888

Résumé

Trichosporon spp. are yeasts capable of causing invasive disease, which mainly affect immunocompromised patients. A clinical strain of T. asahii was isolated from the blood cultures of patients admitted to the General Hospital of Fortaleza. Susceptibility tests were conducted by disk diffusion and broth microdilution. The isolated strain of T. asahii was resistant to fluconazole. The patient used amphotericin B and caspofungin in order to facilitate the microbiological cure. It was the first isolation and identification of T. asahii in blood culture in Ceará, Brazil.


Trichosporon spp. são leveduras capazes de causar doença invasiva, que afetam principalmente pacientes imunocomprometidos. Uma cepa clínica de T. asahii foi isolada em hemocultura de paciente internado no Hospital Geral de Fortaleza. Os testes de suscetibilidade foram realizados por difusão em disco e microdiluição em caldo. A cepa isolada do T. asahii foi resistente ao fluconazol, o paciente fez uso de anfotericina B e caspofungina então a cura microbiológica ocorreu. Foi o primeiro isolamento e identificação de T. asahii em hemocultura no Ceará, Brasil.


Sujets)
Adulte , Humains , Mâle , Amphotéricine B/pharmacologie , Antifongiques/pharmacologie , Infection croisée/microbiologie , Fluconazole/pharmacologie , Trichosporon/effets des médicaments et des substances chimiques , Trichosporonose/microbiologie , Sujet immunodéprimé , Tests de sensibilité microbienne , Trichosporon/isolement et purification , Trichosporonose/traitement médicamenteux
12.
Chinese Medical Journal ; (24): 2632-2635, 2012.
Article Dans Anglais | WPRIM | ID: wpr-283710

Résumé

Trichosporon species now ranks as the second most common cause of disseminated yeast infections with a high mortality rate. Breakthrough trichosporonosis in patients receiving echinocandins therapy is being recognized recently. We present a case of breakthrough trichosporonosis with acute viral myocarditis while receiving caspofungin therapy. Trichosporon infection should be considered in patients, who have risk factors for invasive fungal infection and develop unexplained clinical manifestations of infection despite treatment with echinocandins.


Sujets)
Adulte , Femelle , Humains , Antifongiques , Utilisations thérapeutiques , Échinocandines , Utilisations thérapeutiques , Lipopeptides , Résultat thérapeutique , Trichosporonose , Traitement médicamenteux , Microbiologie
13.
Annals of the Academy of Medicine, Singapore ; : 287-290, 2011.
Article Dans Anglais | WPRIM | ID: wpr-229670

Résumé

<p><b>INTRODUCTION</b>Because invasive fungal infections cause significant morbidity and mortality in liver transplant recipients, the use of antifungal prophylaxis, and the early empirical use of antifungal agents, is widespread on liver transplant units. The new-generation azoles such as voriconazole and the echinocandins have been welcome additions to the antifungal armamentarium. These agents have become the leading options for prophylaxis in liver transplant units, despite the absence of strong data for their efficacy in this setting.</p><p><b>CLINICAL PICTURE</b>We report two recipients of living-donor liver transplants who became infected/colonised with fungi resistant to an echinocandin and the azoles after exposure to these agents. One patient developed trichosporonosis while on caspofungin and the other became infected/ colonised with Candida glabrata that was resistant to voriconazole and posaconazole.</p><p><b>CONCLUSION</b>We report these to highlight some of the consequences of using the newer antifungal agents.</p>


Sujets)
Adulte , Femelle , Humains , Mâle , Adulte d'âge moyen , Jeune adulte , Antifongiques , Utilisations thérapeutiques , Résistance des champignons aux médicaments , Échinocandines , Utilisations thérapeutiques , Issue fatale , Fluconazole , Utilisations thérapeutiques , Lipopeptides , Transplantation hépatique , Allergie et immunologie , Mycoses , Traitement médicamenteux , Pyrimidines , Utilisations thérapeutiques , Triazoles , Utilisations thérapeutiques , Trichosporonose , Traitement médicamenteux , Voriconazole
14.
Korean Journal of Hematology ; : 109-112, 2004.
Article Dans Coréen | WPRIM | ID: wpr-721018

Résumé

Trichosporon beigelii is a causative agent of white piedra, an superficial hair shaft infection in immunocompetent individuals, and rarely of disseminated trichosporonosis in immunocompromised patients especially in neutropenic patients with leukemia. Trichosporon infections in immunocompromised patients are frequently fatal despite therapy with amphotericin B. We describe an acute myelogenous leukemia patient with T. beigelii fungemia after remission induction chemotherapy who was successfully treated with amphotericin B and fluconazole.


Sujets)
Humains , Amphotéricine B , Traitement médicamenteux , Fluconazole , Fongémie , Poils , Sujet immunodéprimé , Leucémies , Leucémie aigüe myéloïde , Neutropénie , Piedra , Induction de rémission , Trichosporon , Trichosporonose
15.
Korean Journal of Clinical Microbiology ; : 151-154, 2002.
Article Dans Coréen | WPRIM | ID: wpr-211682

Résumé

Systemic infection due to Trichosporon beigelii is uncommon but increasingly reported in immunocompromised patients. Trichosporonosis is often refractory to conventional antifungal therapy and frequently fatal. We report a case of systemic T. beigelii infection in a patient with acute leukemia. The 35-year-old male patient had been diagnosed as acute myelogenous leukemia with severe neutropenia and received cytotoxic drug therapy. As a fever developed on the day 21 of chemotherapy, broad spectrum antibiotics were administered empirically. Even though an antifungal drug, amphotericin B was replaced because the blood cultures resulted in T. beigelii, the patient died of the septic shock. We think that T. beigelii should be included as a potential life-threatening pathogen capable of causing widespread systemic disease in the immunocompromised host.


Sujets)
Adulte , Humains , Mâle , Amphotéricine B , Antibactériens , Traitement médicamenteux , Fièvre , Sujet immunodéprimé , Leucémies , Leucémie aigüe myéloïde , Neutropénie , Choc septique , Trichosporon , Trichosporonose
16.
Tuberculosis and Respiratory Diseases ; : 280-284, 1996.
Article Dans Coréen | WPRIM | ID: wpr-10630

Résumé

We report the first case of summer-type hypersensitivity pneumonitis(SHP) in Korea diagnosed by positive serum antibodies to Trichosporon cutaneum. Hypersensitivity pneumonitis(HP) has been commonly classified as an occupational respiratory diseases. However, evidence that sensitizing organisms can also contaminate and cause pulmonary diseases in home environment has been increasing. One such disease is SHP. In Japan, 75% of cases with HP are SHP. Even though there has been no known SHP case in Korea yet, there has been high possibility of SHPs in Korea because our country has areas which have hot and humid summer climate similar to Japan. This first case of SHP in Korea suggests that there may be another cases in Korea and nation-wide survey may be required. We report here the first confirmed case of SHP in Korea.


Sujets)
Anticorps , Climat , Hypersensibilité , Japon , Corée , Maladies pulmonaires , Trichosporon , Trichosporonose
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