Rubic Zana, Novak Anita, Tomic Zvonimir, Goic-Barisic Ivana, Radic Marina, Tonkic Marija
Department of Clinical Microbiology, University Hospital Centre Split, Spinciceva 1, 21000, Split, Croatia,
Mycopathologia. 2015 Feb;179(1-2):125-8. doi: 10.1007/s11046-014-9814-9. Epub 2014 Sep 24.
Trichosporon asahii is a rare but emerging fungal pathogen that causes severe and life-threatening infections with high mortality rate, mostly in immunocompromised patients. It could be easily misdiagnosed due to lack of awareness, especially when invasive or deep-seated infections occur in non-immunocompromised patients, and inadequately treated since the clinical failures and high minimum inhibitory concentrations to some antifungal agents have been described. We present a case of T. asahii catheter-related infection in 66-year-old comatose patient with polytrauma, who was not immunodeficient, but was receiving broad-spectrum antibiotics for a long period. Due to prompt diagnosis and treatment which included catheter replacement and voriconazole, the patient successfully recovered from this infection. The aims of this case report were to highlight the importance of recognizing this otherwise colonizing yeast as potentially dangerous pathogen in non-immunocompromised patients with a long-term antibiotic therapy, and to emphasize the importance of the right therapeutic choice due to its resistance to certain antifungal agents.
阿萨希毛孢子菌是一种罕见但正在出现的真菌病原体，可导致严重且危及生命的感染，死亡率很高，主要发生在免疫功能低下的患者中。由于认识不足，它很容易被误诊，尤其是当非免疫功能低下的患者发生侵袭性或深部感染时，而且由于临床治疗失败以及对某些抗真菌药物的最低抑菌浓度较高，治疗往往不充分。我们报告一例66岁的多发伤昏迷患者发生阿萨希毛孢子菌导管相关感染，该患者无免疫缺陷，但长期接受广谱抗生素治疗。由于及时诊断并进行了包括更换导管和使用伏立康唑在内的治疗，患者成功从感染中康复。本病例报告的目的是强调在长期接受抗生素治疗的非免疫功能低下患者中，认识到这种原本定殖的酵母菌可能是危险病原体的重要性，并强调由于其对某些抗真菌药物耐药，正确选择治疗方法的重要性。
