Allogeneic Hematopoietic Stem Cell Transplantation Combined with Disseminated Infection by Trichosporon Asahii: A Case Study
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Abstract
Invasive fungal infection is a serious complication of allogeneic hematopoietic stem cell transplantation, with a high mortality rate, but data in pediatric population is limited. The most common fungal pathogens are Candida and Aspergillus; however, some other rare fungal pathogens can cause severe clinical manifestation. We describe a case of catheter-related T. asahii bloodstream infection of the 24-month-old boy who was in the neutropenic period after allogeneic stem cell transplantation for Mucopolysaccharidoses type 2. We successfully treated him with intravenous voriconazol and a second haploidentical stem cell transplantation without any serious complications due to fungal infection. Clinicians should consider the possibility of Trichosporin infections in neutropenic patients if symptoms do not improve despite proper treatment with various antibiotics and/or antifungal agents.
Article Details
Keywords
Invasive fungal infection, Trichosporon asahi, Neutropenia, Allogeneic hematopoietic stem cell transplantation
References
2. lhaj Mahmoud D, Hérivaux A, Morio F, et al. The epidemiology of invasive fungal infections in transplant recipients. Biomed J. 2024; 47(3): 100719. doi:10.1016/j.bj.2024.100719.
3. Bretagne S, Sitbon K, Desnos-Ollivier M, et al. Active Surveillance Program to Increase Awareness on Invasive Fungal Diseases: the French RESSIF Network (2012 to 2018). mBio. 2022; 13(3): e0092022. doi:10.1128/mbio.00920-22.
4. Nguyen, M. H., Ostrosky-Zeichner, L., Pappas, P. G., Walsh, T. J., Bubalo, J., Alexander, B. D., et al. 3rd, real-world use of mold-active triazole prophylaxis in the prevention of invasive fungal diseases: results from a subgroup analysis of a multicenter national registry. Open Forum Infect. Dis. 2023; 10, ofad424. doi: 10.1093/ofid/ofad424.
5. Lamoth, F., Chung, S. J., Damonti, L., and Alexander, B. D. Changing epidemiology of invasive mold infections in patients receiving azole prophylaxis. Clin. Infect. Dis. 2017. 64, 1619-1621. doi: 10.1093/cid/cix130.
6. Guo LN, Yu SY, Hsueh PR, et al. Invasive Infections Due to Trichosporon: Species Distribution, Genotyping, and Antifungal Susceptibilities from a Multicenter Study in China. J Clin Microbiol. 2019; 57(2): e01505-18. Published 2019 Jan 30. doi:10.1128/JCM.01505-18.
7. Busca A, Cinatti N, Gill J, et al. Management of Invasive Fungal Infections in Patients Undergoing Allogeneic Hematopoietic Stem Cell Transplantation: The Turin Experience. Front Cell Infect Microbiol. 2022;11:805514. Published 2022 Jan 7. doi:10.3389/fcimb.2021.805514.
8. Mehta V, Chander J, Gulati N, et al. Epidemiological profile and antifungal susceptibility pattern of Trichosporon species in a tertiary care hospital in Chandigarh, India. Curr Med Mycol. 2021; 7(1): 19-24. doi:10.18502/cmm.7.1.6179.
9. Minh, P. N., Huyền, C. V., Duấn, P. N., Ngọc, P. T. B., Huệ, N. T., Lâm, T. K., Thanh, H. T. P., Băng, V. T. T., Sơn, Đỗ T., & Bích, N. N. Nhiễm nấm trichosporon asahii đường tiết niệu ở bệnh nhân sau phẫu thuật tán sỏi nội soi niệu quản ngược dòng: Báo cáo nhân 1 trường hợp. Tạp chí Nghiên cứu Y học. 2024; 185(12), 408-411. https://doi.org/10.52852/tcncyh.v185i12.2841.
10. Alp S, Gulmez D, Ayaz CM, Arikan-Akdagli S, Akova M. Fungaemia due to rare yeasts in a tertiary care university centre within 18 years. Mycoses. 2020; 63(5): 488-493. doi:10.1111/myc.13072.
11. Kurakado S, Miyashita T, Chiba R, Sato C, Matsumoto Y, Sugita T. Role of arthroconidia in biofilm formation by Trichosporon asahii. Mycoses. 2021; 64(1): 42-47. doi:10.1111/myc.13181.
12. Colombo AL, Padovan AC, Chaves GM. Current knowledge of Trichosporon spp. and Trichosporonosis. Clin Microbiol Rev. 2011; 24(4): 682-700. doi:10.1128/CMR.00003-11.
13. Francisco EC, de Almeida Junior JN, Queiroz-Telles F, et al. Correlation of Trichosporon asahii Genotypes with Anatomical Sites and Antifungal Susceptibility Profiles: Data Analyses from 284 Isolates Collected in the Last 22 Years across 24 Medical Centers. Antimicrob Agents Chemother. 2021; 65(3): e01104-20. Published 2021 Feb 17. doi:10.1128/AAC.01104-20.
14. Liao Y, Hartmann T, Ao JH, Yang RY. Serum glucuronoxylomannan may be more appropriate for the diagnosis and therapeutic monitoring of Trichosporon fungemia than serum β-D-glucan. Int J Infect Dis. 2012; 16(8): e638. doi:10.1016/j.ijid.2012.03.009.
15. Chen J, Chen F, Wang Y, et al. Use of combination therapy to successfully treat breakthrough Trichosporon asahii infection in an acute leukemia patient receiving voriconazole. Med Mycol Case Rep. 2014;6:55-57. Published 2014 Oct 19. doi:10.1016/j.mmcr.2014.09.003.