A Case of Disseminated Trichosporon beigelii Infection Treated with the Combination of Amphotericin B and Fluconazole / 대한임상미생물학회지

Trichosporon beigelii is often resistant to the fungicidal effect of amphotericin B and can cause fatal disseminated infections in immunocompromised patients. We report a case of a disseminated T. beigelii infection with a favorable outcome in a patient with acute erythroleukemia and neutropenia. The patient presented a persistent fever, multiple erythematous skin lesions, and pulmonary infiltrates. T. beigelii was isolated from blood cultures in four days and also from cultures of abdominal skin lesion, sputum, and stool. The isolate was resistant to amphotericin B (MIC, 2 microgram/mL), and the respective fluconazole and itraconazole MICs were 4 and 1 microgram/mL. The patient was successfully treated with fluconazole plus amphotericin B in combination with granulocyte colony stimulating factor and leukocyte transfusion. This case shows the importance of early diagnosis and treatment with combination of amphotericin B and fluconazole as a prognostic factor of disseminated T. beigelii infections.

A Case of Trichosporon beigelii Fungemia Treated with Amphotericin B and Fluconazole in a Patient with Acute Myelogenous Leukemia / 대한혈액학회지

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.

A Case of Trichosporon beigelii Peritonitis in CAPD / 대한신장학회잡지

Fungal peritonitis is one of the leading causes of patient dropout from continuous ambulatory peritoneal dialysis (CAPD) therapy. Although the most causative agents of peritonitis associated with CAPD are bacteria, fungi are implicated in up to 10% of cases. The most common organism of fungal peritonitis is Candida specises, but Trichosporon beigelii was reported as a rare causative agent of fungal peritonitis. We experienced a case of CAPD peritonitis by Trichosporon beigelii, which was treated with CAPD catheter removal, and antifungal agents with amphotericin B and fluconazole. Thus, we report our experience of CAPD peritonitis caused by Trichosporon beigelii and review of the literature.

A Case Report of Invasive Infection due to Trichosporon beigelii in a Patient with Acute Leukemia / 대한임상미생물학회지

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.

An ALL Case with Trichosporon beigelii Pneumonia Developed during Severe Pancytopenic Period after Salvage Chemotherapy / 대한혈액학회지

Trichosporon beigelii belongs to the family of Cryptococcaceae. T. beigelii is a rare causative agent of invasive pneumonia in immunocompromised patients. T. beigelii pneumonia is characterized by persistent fever unresponsive to broad-spectrum antibiotic the- rapy, coughing with bloody sputum, and rapidly progressive dyspnea. Its diagnosis should be based on clinical suspicion and confirmed by culture and histologic examination of biopsy tissue. We describe an ALL patient with T. beigelii pneumonia developed during severe pancytopenic period after salvage chemotherapy.

A Case of Trichosporon beigelii Pneumonia in a Boy with Normal Immunological Status

Invasive diseases caused by Trichosporon beigelii are rare, usually fatal, opportunistic infections that occur exclusively in immunocompromised patients. This fungus has been known to produce cutaneous involvement in immunocompetent hosts, and is rarely reported to cause systemic disease in patients with cardiac valve replacement. In this report, we described a case of invasive Trichosporon beigelii pneumonia in a 9-year-old boy who presented with persistent cough and dyspnea for 1 week. He showed no abnormality in immunologic function tests and had no predisposing factors. Trichosporon beigelii was isolated from the bronchoalveolar lavage culture.

Onychomycosis and Trichosporon beigelii / 대한피부과학회지

BACKGROUND: Onychomycosis is a common superficial fungal infection. Causative organisms in onychomycosis have been extensively studied, but the role of non-dermatophytes is controversial. Trichosporon beigelii are soil and water inhabiting yeasts, occasionally found in flora normally associated with human skin, mouth, and nails. Several reports in the literature have suggested that T. beigelii is one of the pathogens in onychomycosis. OBJECTIVE: We performed mycologic studies to investigate the causative organisms of onychomycosis and to confirm the pathogenic role of T. beigeliis in onychomycosis. METHODS: We performed a survey of the mycologic labaratory records of patients clinically suspected of onychomycosis from July 1996 to December 1998. RESULTS: 1) Out of a total of 1934 nail samples examined, 928(48.0%) of these were culture positive, including 192(10.8%)cases with T. beigelii. 2) The overall positive rate for the KOH mount examination was 59% and in the cases with T. beigelii was 89.1%. 3) Among the age groups, the incidence rate was highest in the fifth decade(26.6%). 4) The monthly prevalence of onychomycosis was highest in July(10.6%), the distribution of T. beigelii was high in July and August. 5) The most common causative organism of onychomycosis was Trichophyton rubrum(62.0%), and the others in decreasing frequency were T. beigelii(20.7%), Candida spp.(7.2%), Trichophyton mentagrophytes(4.0%) and mixed infection(2.2%). 6) T. beigelii was repeatedly isolated in the successive nail cultures from 10 out of 20 patients with T. beigelii nail infection. CONCLUSION: T. beigelii was the second commonly isolated fungus in onychomycosis had the high positive rate of the which KOH mount examination on nails and successive repeated cultures. We suggest that T. beigelii might be a pathogen of onychomycosis.

A Case of Trichosporon beigelii Esophagitis Presenting Hematemesis with a Large Amorphous Material / 대한소아소화기영양학회지

We experienced a case of Trichosporon beigelii esophagitis in a 16-month-old boy who was presented with hematemesis with a large amorphous material. A spit-out material was silky, 10 x 1.2 cm in size and like a part of hollow viscus organ. Emergent gastrofiberscopy revealed that this silky material was teared up from upper and to lower esophagus and was threw with hematemesis. It was suggested that pseudomembrane on esophagus was peeled off followed by mucosal bleeding. Pathologic study revealed this material was pseudomembrane with esophageal mucosa of T. beigelii esophagitis and was teared at lamina propria level from submucosa.

Tinea pedis in garbage workers / 대한피부과학회지

Tinea pedis is frequently found in people with poor personal hygiene and in hot, humid environments. The authors investigated the clinical, epidemiological, and mycological characteristics of tinea pedis in 170 garbage workers(166 males and 4 females) employed in a garbage plant in Seoul, Korea. 40 were clerical workers and 130 were field workers. Tinea pedis was found in 134 with a prevalence rate of 78.8%. Of those 134, 61(45.5%) also had onychomycosis. The prevalence of tinea pedis increased with age and the period working in garbage plant. However, there was no difference in the prevalence of tinea pedis between clerical workers and field workers, mitigating against the conclusion that their tinea pedis may be of occupational origin. Clinically tinea pedis was classified into 4 types ; interdigital (41.8%), vesicular(23.1%), dry squamous(22.4%), and mixed(12.7%). KOH smear positivity and culture positivity was related to clinical types of the lesion the lowest in the interdigital type. In the interdigital type, the etiology of nonmycotic lesions could not be identified. Negative fungal cultures could have been due to secondary bacterial infections. 63 strains of dermatophytes were isolated; 54 strains of Trichophyton rubrem(85.7%), 8 strains of Trichophyton mentagrophytes(12.7%) and 1 mixed infection of T. rubrum and T. mentagrophytes. T. mentagrophytes was isolated only from the vesicular lesions. 8 strains of yeast forms, positive in KOH smears and yielding pure colonies, were also isolated, and repeated mycologic examination yielded the same results. Among them, at least 4 cases of Trichosporon beigelii, and 1 case of Candida parapsilosis were considered to be of pathogenic significance.

Tinea pedis in sewerage workers / 대한피부과학회지

Tinea pedis is frequently found in those people with poor hygine and in hot and humid environments. The authors investigated the clinical, epidemiologicol a id mycological characteristics of tinea pedis in 138 sewerage workers attending a sewerage plant in Seoul. Tinea pedis was found in 82, with a prevalence of 59.4%. The prevalence of tinea pedis increased with age and the period working at sewerage plant, however, there was no statistical significance. Also there was no difference in the prevalence of tinea pedis between the clerical workers and the field workers. Positive rate for KOH smear was 73.2%, and culture positive rates were 42.7%, producing 35 strains of dermatophytes. Twertyeight strains of Trichophyton Rubrum and 7 strains of Trichophyton mentagrophytes were isolated. Twentyseven yeast-form colonies were isolated, and Trichosporon beigelii was foungl in 19 samples. Most of the yeast forms were found mixed with dermatophytes and moulcis, However, 6 were isolated from direct smear positive cases and yieIded pure colonies of yeast. These included 4 cases of T. beigelii, 1 case of Candida parapsilosis, and 1 case of Candida hormicola. In view of the recent report of these fungi as pathogenic organism, these isolates, rspecially T. beigelii, were considered as a causative agent of tinea pedis in certain groups like sewerage workers.