Recurrent trichosporonosis with central nervous system involvement in an allogeneic hematopoietic stem cell transplant recipient

S Y Thien; S J Chung; A L Tan; W Y K Hwang; B H Tan; T T Tan

doi:10.1111/tid.12577

Recurrent trichosporonosis with central nervous system involvement in an allogeneic hematopoietic stem cell transplant recipient

Transpl Infect Dis. 2016 Oct;18(5):768-772. doi: 10.1111/tid.12577. Epub 2016 Sep 7.

Authors

S Y Thien¹, S J Chung¹, A L Tan², W Y K Hwang³, B H Tan¹, T T Tan⁴

Affiliations

¹ Department of Infectious Diseases, Singapore General Hospital, Singapore.
² Department of Pathology, Singapore General Hospital, Singapore.
³ Department of Hematology, Singapore General Hospital, Singapore.
⁴ Department of Infectious Diseases, Singapore General Hospital, Singapore. [email protected].

PMID: 27425395
DOI: 10.1111/tid.12577

Abstract

Trichosporon is an ubiquitous yeast that has emerged as an opportunistic pathogen in the immunocompromised host. We describe a case of invasive trichosporonosis in an allogeneic hematopoietic stem cell transplant (allo-HSCT) recipient while on caspofungin antifungal prophylaxis. She developed disseminated trichosporonosis in the pre-engraftment period and was successfully treated with voriconazole. She later developed 2 further episodes of invasive trichosporonosis involving the central nervous system. This case highlights the challenges of managing trichosporonosis in allo-HSCT recipients and suggests the need for lifelong therapy in some patients.

Keywords: Trichosporon asahii; aplastic anemia; central nervous system infection; hematopoietic stem cell transplant; hydrocephalus; trichosporonosis.

Publication types

Case Reports

MeSH terms

Anemia, Aplastic / therapy*
Antibiotic Prophylaxis / methods*
Antifungal Agents / administration & dosage
Antifungal Agents / therapeutic use*
Caspofungin
Central Nervous System / diagnostic imaging
Central Nervous System / microbiology*
Echinocandins / administration & dosage
Echinocandins / therapeutic use
Female
Hematopoietic Stem Cell Transplantation / adverse effects*
Humans
Hydrocephalus / etiology
Hydrocephalus / surgery
Immunocompromised Host
Immunosuppression Therapy / adverse effects
Laminectomy
Lipopeptides / administration & dosage
Lipopeptides / therapeutic use
Magnetic Resonance Imaging
Opportunistic Infections / cerebrospinal fluid
Opportunistic Infections / complications
Opportunistic Infections / drug therapy*
Opportunistic Infections / microbiology
Recurrence
Transplantation, Autologous
Treatment Outcome
Triazoles / administration & dosage
Triazoles / therapeutic use
Trichosporon / isolation & purification*
Trichosporonosis / cerebrospinal fluid
Trichosporonosis / complications
Trichosporonosis / drug therapy*
Trichosporonosis / microbiology
Ventriculoperitoneal Shunt
Voriconazole / administration & dosage
Voriconazole / therapeutic use

Substances

Antifungal Agents
Echinocandins
Lipopeptides
Triazoles
posaconazole
Caspofungin
Voriconazole