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INVASIVE TRICHOSPORONOSIS CAUSED BY TRICHOSPORON ASAHII IN A POLYTRAUMATIZED NEUROSURGICAL PATIENT: CASE REPORT
MAJA TOMIĆ PARADŽIK
; Department of Microbiology, Institute of Public Health, Brod-Posavina County,Slavonski Brod, Croatia
JOSIP MIHIĆ
; Section of Neurosurgery, Department of Surgery, Dr. Josip Benčević General Hospital, Slavonski Brod, Croatia
JASMINKA KOPIĆ
; Department of Anesthesiology, Resuscitation and Intensive Care, Dr. Josip Benčević General Hospital,
EMILIJA MLINARIĆ MISSONI
; Department of Mycology, Croatian Institute of Public Health, Zagreb, Croatia
Abstract
Trichosporon asahii (formerly T. beigelii) is a rare cause of human infections with very varied clinical manifestations ranging from superficial infections to severe and systemic diseases. T. asahii is a life-threatening opportunistic pathogen especially for granulocytopenic, immunocompromised and immunodeficient patients. It is the possible cause of summer-type hypersensitivity pneumonitis in Japan and systemic infections in transplant patients, patients on corticosteroid therapy, patients with solid tumors and burn patients. Cases of infection in non-immunocompromised surgical patients and patients with long-term stay in ICU are described in the literature. We report on T. asahii fungemia in a polytraumatized neurosurgical patient with long-term stay in the hospital. Urinary tract was the source of fungemia, with the same pathogen isolated from urine and blood at the same time. In the Referral Center for Systemic Mycoses, Croatian Institute of Public Health, Zagreb, the strain from the urine and blood culture was identified as T. asahii, with good susceptibility to fluconazole, voriconazole and 5 fluorocytosine, reduced susceptibility to itraconazole and resistance to amphotericin B. The patient responded to fluconazole therapy very well. Since systemic trichosporonoses are generally associated with immunocompromised patients (hematologic, granulocytopenic and AIDS patients), thiscase confirms the possibility of infection with this pathogen in patients with long-term hospital stay and reduced local immunity, but without classic immunodeficiency.
Keywords
invasive trichosporonosis; polytrauma; Trichosporon asahii
Hrčak ID:
104185
URI
Publication date:
20.6.2013.
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