Raju Dona S, Sugunan Aadharsa, Keechilattu Pavithran, Philip Arun, Reghu Remya
Department of Pharmacy Practice, Amrita School of Pharmacy.
Department of Medical Oncology and Hematology, Amrita Institute of Medical Sciences and Research Center, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India.
J Pediatr Hematol Oncol. 2020 Apr;42(3):e193-e194. doi: 10.1097/MPH.0000000000001420.
Trichosporon asahii is a rare opportunistic fungal pathogen that causes fatal systemic infection in immunocompromised patients. Neutropenia developing due to malignancies is an important risk factor for fungal infection. Invasive infections due to T. asahii can be divided into disseminated and localized forms. The disseminated form is more common and usually occurs in neutropenic patients. The patient typically has an acute febrile illness that progresses rapidly to multiorgan failure. Here, we are presenting a case of fungal sepsis by invasive T. asahii in a 1-year-old child with Wilms Tumor. To the best of our knowledge, this is the first time that fungal sepsis due to T. asahii has been reported in a Wilms tumor patient. The incidence of rare invasive fungal infections is increasing in immunocompromised patients in whom management becomes difficult due to their heterogenous antifungal susceptibility pattern and intrinsic resistance to the standard antifungal agents that are routinely given. The patient was admitted with high spiking fever, and his laboratory investigations suggested neutropenia. T. asahii was isolated from the blood culture, for which he was started on inj. voriconozole. After 14 days of treatment, the fungus was cleared out from the patient's blood.
阿萨希毛孢子菌是一种罕见的机会性真菌病原体，可在免疫功能低下的患者中引起致命的全身感染。因恶性肿瘤导致的中性粒细胞减少是真菌感染的重要危险因素。阿萨希毛孢子菌引起的侵袭性感染可分为播散型和局限型。播散型更为常见，通常发生在中性粒细胞减少的患者中。患者通常患有急性发热性疾病，并迅速进展为多器官功能衰竭。在此，我们报告一例1岁患有肾母细胞瘤的儿童发生阿萨希毛孢子菌侵袭性真菌败血症的病例。据我们所知，这是首次报道肾母细胞瘤患者发生阿萨希毛孢子菌引起的真菌败血症。在免疫功能低下的患者中，罕见侵袭性真菌感染的发生率正在上升，由于其抗真菌药敏模式各异且对常规使用的标准抗真菌药物具有固有耐药性，这类患者的治疗变得困难。该患者因高热入院，实验室检查提示中性粒细胞减少。从血培养中分离出阿萨希毛孢子菌，为此开始给他静脉注射伏立康唑。治疗14天后，真菌从患者血液中清除。
