Fluconazole therapy in a rhesus monkey macaca mulatta. A case of trichosporon beigelii endocarditis, european. The name trichosporon cutaneum is often used synonymously with trichosporon beigelii. Invasive trichosporonosis due to trichosporon asahii in a.
Recent molecular studies have altered the taxonomy and with it the species names associated with various ailments. The nomenclature for this genus has undergone taxonomic revision, and the old trichosporon beigelii also called t. Thus, the pathogenesis of trichosporon infection in the icu setting may be similar to that of the more commonly observed candida infection. Sep 01, 2001 trichosporon asahii formerly trichosporon beigelii is an emerging fungal pathogen seen particularly in immunologically compromised patients. We contructed a readily used and accurate identification system for all of the species in the genus trichosporon, including the six medically relevant species, based on additional analysis of biochemical. New identification of trichosporon species isolated from. Trichosporon asahii causes white piedra, an infection of hair shafts and onychomycosis in immunocompetent patients, as well as various localized or disseminated invasive infections in immunodeficient hosts. Aug 21, 2014 trichosporon asahiitaking a step back, these are the t. A 45yearold man from nepal with a year history of polycystic kidney disease was diagnosed as suffering from chronic renal failure with endstage renal disease. Trichosporon beigelii fungemia and cutaneous dissemination. Trichosporon loubieri infection in a patient with adult.
Trichosporon inkin as an emergent pathogen in patients. Current taxonomy of trichosporon spp traditional taxonomy based on phenotypic characterization of fungal organisms generates inconsistent data when applied to the genus trichosporon, as it aggregates within the same taxon isolates with genetically heterogeneous behavior. However, many cases of invasive trichosporonosis caused by different newly delineated species of trichosporon have been published in. Antibodies to a range of antigens 200 to 16 kilodaltons were detectable in three patients with invasive trichosporon beigelii or blastoschizomyces capitatus infections and 10 uninfected controls. Trichosporon asahii trichosporon beigelii infections are rare but have been associated with a wide spectrum of clinical manifestations, ranging from superficial involvement in immunocompetent individuals to severe systemic disease in immunocompromised patients. Infection with trichosporon pullulans annals of internal. Serological characterization of trichosporon cutaneum and related species reiko ikeda.
Biochemical and morphologic differences within the genus have led to the division of the former t beigelii into distinct species, at least 9 of which have the potential to cause human disease. We describe a 26week gestation 890g vaginally delivered female neonate who had severe respiratory distress syndrome and on the sixth day of life developed klebsiella pneumoniae. Invasive infection due to trichosporon species is rare. The colonies are usually raised and have a waxy appearance, which develop radial furrows and irregular folds.
Fungemia due to trichosporon mucoides in a diabetes. Trichosporon beigelii fungemia and multiple, purpuric, papular skin lesions developed on the chest wall and extremities of a 22yearold man with acute granulocytic leukemia. Two patients had acute leukemia and one patient had a lymphoblastic lymphoma. Patterns of morphologic variation among isolates of trichosporon beigelii. Voriconazole and posaconazole show excellent in vitro activity against trichosporon. Trichosporon species are soil inhabitants and can be part of the normal flora of the human skin and gastrointestinal tract.
Trichosporon grows as a yeast, both at room temperature and at 37. Feb 12, 2018 all pathogenic members of the genus trichosporon were once regarded as a single species, t beigelii. Of the 52 cases identified, 17 were classified as trichosporon sp. Sep 28, 2019 trichosporon beigelii is a species of fungus in the family trichosporonaceae. However, in the past two decades trichosporon species have emerged as important opportunistic pathogens in immunocompromised individuals previously, the classification and nomenclature of trichosporon. Trichosporon beigelii is a minor component of normal skin flora, and is widely distributed in nature, but nevertheless is the most significant pathogen in the genus trichosporon. Most are typically isolated from soil, but several species occur as a natural part of the skin microbiota of humans and other animals. Trichosporon asahii infection in an hivpositive patient. This misclassification was the result of the absence of simple methods to distinguish among the species in the microbiology laboratory.
Onychomycosis and trichosporon beigelii in korea request pdf. Fatal, complete splenic infarction and hepatic infection due. White piedra is an uncommon infection caused by yeasts of the genus trichosporon, namely, trichosporon ovoides scalp hair, trichosporon inkin pubic hair, and trichosporon asahii rare in piedra. Treatment for pemphigus relies on systemic corticosteroids, usually administered with other immunosuppressant agents. Partial sequencing of the small and large subunits of the rrna have clearly delineated numerous species. Trichosporon asahii, a noncandida yeast that caused fatal. Disseminated trichosporonosis due to trichosporon asahii. A multicenter retrospective study was conducted to characterize cases of proven or probable invasive trichosporonosis diagnosed over the past 20 years in italian patients with hematological diseases. Fungemia due to trichosporon asahii in a neutropenic child and blood stream infection due to trichosporon beigelii in a burn patient have already been reported. Catheterrelated fungemia caused by trichosporon beigelii in nonneutropenic patients. Trichosporon beigelii definition of trichosporon beigelii.
Clinical breakpoints have not been defined for trichosporon species, and the mics cannot be reliably interpreted as indicating resistance or susceptibility. Invasive trichosporonosis caused by trichosporon asahii. We observed considerable variability in colony and microscopic morphology among isolates of trichosporon beigelii. Trichosporon beigelii an overview sciencedirect topics. Invasive infections with trichosporon beigelii also called cutaneum or t. To assess the occurrence of white piedra and the asymptomatic carriage rate of t beigelii, 100 heterosexual and 49 homosexualbisexual men were entered into the study. White piedra is a superficial fungal infection of the hair shaft, caused by trichosporon beigelii, also known as tinea nodosa, trichosporonosis nodosa and trichomycosis nodularis. In particular, the name trichosporon beigelii is now obsolete, and previously described infections reported in the literature under this name could in fact be due to any one of the species listed below. Trichosporon is a genus of anamorphic fungi in the family trichosporonaceae. Laboratory studies confirmed fungemia with trichosporum beigelii, and contrastenhanced computed tomography of the abdomen demonstrated numerous lowattenuation liver lesions and a hypodense spleen with capsular enhancement. Infection appears to begin just beneath the hair shaft to form soft white to. Trichosporon pullulans phadia setting the standard.
Six of them are pathogenic to humans and occupy different niches on the. Common areas of involvement include distal portions of facial, beard, moustache and pubic hairs, with the scalp being rarely involved. Little is known of the host defence mechanisms against this yeast. Immunoblot analysis of the serological response in invasive. Factors that enhance mucosal colonization and subsequent invasion of trichosporon species include broadspectrum antibiotic treatment and breaks in mucosal barriers 7, 9, 26, 45. We report on a 56yearold woman with acute lymphocytic leukemia who presented with right upper quadrant pain, fever, nausea, and vomiting. Only one patient recovered after antimycotic therapy and concomittent remission of his. We here report a successfully treated case of disseminated trichosporonosis in a known diabetic, 14. This system utilized 2 pan trichosporon probes designed to hybridize to the its2 region, which is highly variable among the genomes of individual fungal species, and it detected at least four clinically relevant trichosporon species t.
Summary trichosporon beigelii has emerged as a lethal opportunist pathogen in granulocytopenic and corticosteroidtreated patients. T1 fluconazole therapy in a rhesus monkey macaca mulatta with epidural trichosporon beigelii in a cephalic recording cylinder. Pronunciation of trichosporon beigelii with 1 audio pronunciation and more for trichosporon beigelii. Trichosporon asahii formerly known as trichosporon beigelii and cutaneum is a basidiomycetous yeast.
Links to pubmed are also available for selected references. Trichosporon species and blastoschizomyces capitatus. Trichosporon asahii formerly trichosporon beigelii is an emerging fungal pathogen seen particularly in immunologically compromised patients. Hay, in mandell, douglas, and bennetts principles and practice of infectious diseases eighth edition, 2015. The primary attack was initiated by a monooxygenation step, resulting in the formation of 4hydroxydiphenyl ether, 2hydroxydiphenyl ether and 3hydroxydiphenyl ether 48. Multidrugresistant trichosporon asahii infection of. Jul 01, 2009 trichosporon species are soil inhabitants and can be part of the normal flora of the human skin and gastrointestinal tract. Although considered a noninvasive fungus, several a case of trichosporon beigelii fatal cases of trichosporon infection have been endocarditis described, mostly in patients with cancer 1 or aids 2 or following transplantation 3. Invasive infections caused by trichosporon species and. Histologically, the skin lesions demonstrated dermal budding yeasts, which were identified as t beigelii in culture. Trichosporon beigelii sbug 752 was able to transform diphenyl ether. Trichosporon species are ureasepositive, nonencapsulated basidiomycetous yeasts characterised by the development of hyaline, septate hyphae that fragment into oval or rectangular arthroconidia. According to the new taxonomic revision of the genus trichosporon, six species, namely, t. Disseminated trichosporon beigelii infection in patients with malignant diseases.
Two hundred and eight isolates of trichosporon beigelii were identified over the period january 1973 to july 1983. It is this form that makes trichosporon a yeastlike fungus. Serological characterization of trichosporon cutaneum and. Trichosporon medical definition merriamwebster medical. White piedra of the scrotal hair was discovered in a total of four 2. Proliferation of trichosporon yeasts in the hair can lead to an unpleasant but nonserious condition. Invasive trichosporonosis caused by trichosporon asahii and. Trichosporon species are widely distributed in nature and can occasionally belong to the human microbiota. Every page goes through several hundred of perfecting techniques. Recent molecular biological, chemical, physiological and morphological studies indicate that trichosporon cutaneum and related species should be reclassified. Multiple species of the genus trichosporon used to be called collectively t. Invasive trichosporonosis due to trichosporon asahii in a non. In this study, antigenic characteristics of the species were determined.
Deeply invasive clinical isolates showed four distinct morphotypes and spontaneous conversions among certain morphotypes and grew well at 37 degrees c. The infection occurs in both the tropics and temperate zones. Gmcsfmodulated phagocytosis of trichosporon beigelii by. We describe the first human infection with a related organism, t. The interaction between human neutrophils and serumopsonised t. David weedon ao md frcpa fcaphon, in weedons skin pathology third edition, 2010.
Trichosporonblood stream infection article pdf available in the journal of the association of physicians of india 67march 2019. However, in the past two decades trichosporon species have emerged as important opportunistic pathogens in immunocompromised individuals. Jan 14, 2004 we report on a 56yearold woman with acute lymphocytic leukemia who presented with right upper quadrant pain, fever, nausea, and vomiting. Immunoblot analysis of the serological response in. Laboratory studies confirmed fungemia with trichosporum beigelii, and contrastenhanced computed tomography of the abdomen demonstrated numerous lowattenuation liver lesions and a hypodense spleen with capsular enhancement suggestive of complete splenic.
Five species of trichosporon are generally considered to be of clinical significance, these being t. Trichosporon asahii, a non candida yeast that caused. Trichosporon asahii the most common cause of disseminated disease, trichosporon inkin the cause. Trichosporon inkin peritonitis treated with caspofungin. Bloodstream infection due to trichosporon beigelii in a burn patient. Blood cultures in two patients and cerebrospinal fluid in the third patient were positive for t. Three new cases of systemic mycosis due to trichosporon cutaneum are reported and compared with the 23 previous reports.
This organism is a ubiquitous saprophytic fungus that is a potential pathogen, especially in the immunocompromised host. It is a yeast that was formerly considered to be the cause of an unpleasant hair condition called white piedra and also the cause of a more serious severe opportunistic infection trichosporonosis in immunocompromised individuals. A case of invasive trichosporonosis due to trichosporon asahii in an otherwise healthy young adult male presenting as meningoencephalitis and pneumonia is reported here. Systemic infections withtrichosporon beigelii cutaneum.
There are now 100 reported cases of hematogenously disseminated infections with this lifethreatening yeast, and no effective antifungal therapy is available. Trichosporon asahii an overview sciencedirect topics. A left nephrectomy was performed, and after 4 months, he received a kidney transplant. Fatal, complete splenic infarction and hepatic infection. After receiving empirical antituberculosis treatment, he was treated with broadspectrum antibiotics.
Recent research, however, has shown that several trichosporon species are involved in. Trichosporonosis is an uncommon but frequently fatal mycosis in immunocompromised patients. Trichosporon beigelii is a species of fungus in the family trichosporonaceae. Fungemia due to trichosporon mucoides in a diabetes mellitus. Trichosporon is a genus characterized by the production of true hyphae and pseudohyphae, arthroconidia and blastoconidia. Fluconazole therapy in a rhesus monkey macaca mulatta with. Hassan, has also been described in patients after cataract g. Treatment controls disease activity but may lead to severe infections. Patterns of morphologic variation among isolates of. Most cases have been reported in cats and consist of nasal granulomas associated with t. An organism widely distributed in soil, stagnant and fresh water and animal excreta isolated from normal skin, urinary, respiratory, gi tract. All species of trichosporon are yeasts with no known teleomorphs sexual states.
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