Infectious Diseases, Internal Medicine, Hospital Pablo Tobón Uribe, Universidad de Antioquia, calle 78B#69-240, Cra. 51d#62-29, Medellín, Colombia.
Infectious Diseases, Internal Medicine, Hospital Universitario San Vicente Fundación Universidad de Antioquia, Cra. 51d#62-29, Medellín, Colombia.
Mycopathologia. 2020 Apr;185(2):377-388. doi: 10.1007/s11046-019-00416-w. Epub 2019 Dec 18.
Cases of invasive Trichosporon infections have increasingly emerged; it is now the second leading cause of yeast bloodstream infections after Candida spp., particularly in the immunosuppressed population, where it often causes breakthrough fungemia with high mortality.
We present a case report of a breakthrough Trichosporon asahii infection in a patient with acute myeloid leukemia and review all of the cases of breakthrough Trichosporon spp. infections published in the literature to date.
We extracted 68 cases of breakthrough Trichosporon spp. infections, wherein 95.5% patients had hematological malignancy, 61.8% of them occurred in the presence of echinocandins, 22% of triazoles, 13.2% of amphotericin and 3% of other combinations of antifungals. The most prevalent manifestation was fungemia (94%); 82.8% of these were associated with the presence of a central venous catheter. The overall mortality was 68.7%; the patients who survived recovered from the neutropenic event.
Invasive trichosporonosis is an acute fatal condition that occurs in immunosuppressed patients, usually under antifungal selective pressure. Typically, neutropenia and its underlying diseases are associated with adverse outcomes.
侵袭性 Trichosporon 感染的病例日益增多；现在它是仅次于念珠菌属的第二大酵母血流感染原因，尤其是在免疫抑制人群中，它常导致具有高死亡率的突破性真菌血症。
我们报告了一例急性髓系白血病患者发生突破性荚膜组织胞浆菌感染的病例，并回顾了迄今为止文献中所有报道的突破性 Trichosporon 属感染病例。
我们提取了 68 例突破性 Trichosporon 属感染病例，其中 95.5%的患者患有血液系统恶性肿瘤，61.8%的病例在使用棘白菌素时发生，22%的病例使用唑类药物，13.2%的病例使用两性霉素，3%的病例使用其他抗真菌药物组合。最常见的表现是真菌血症（94%）；其中 82.8%与中心静脉导管的存在有关。总的死亡率为 68.7%；存活的患者从中性粒细胞减少症中恢复。
侵袭性毛孢子菌病是一种发生在免疫抑制患者中的急性致命疾病，通常在抗真菌药物的选择性压力下发生。通常情况下，中性粒细胞减少症及其潜在疾病与不良结局相关。
