Department of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuoka-shimoaizuki, Eiheiji-cho, Fukui, Yoshida-gun, 910-1193, Japan.
Department of Infection Control and Prevention, University of Fukui Hospital, Fukui, Japan.
Mycopathologia. 2021 Mar;186(1):113-117. doi: 10.1007/s11046-020-00525-x. Epub 2021 Jan 3.
Invasive trichosporonosis is a rare and lethal fungal infection that occurs in immunocompromised patients. Breakthrough trichosporonosis can occur in patients treated with echinocandins since Trichosporon spp. are resistant to these antifungal agents. We report a case of breakthrough Trichosporon asahii fungemia. A 62-year-old Japanese woman with relapsed follicular lymphoma was treated empirically with broad-spectrum antibiotics and micafungin due to an intermittent fever during reinduction chemotherapy. After four cycles of anti-cancer chemotherapy, she experienced a high neutropenic fever and T. asahii was subsequently detected from a blood culture. The patient was not given voriconazole due to the contraindication for use with carbamazepine, and she was successfully treated with fluconazole plus liposomal amphotericin B without any serious complications. The combined therapy of fluconazole and liposomal amphotericin B may therefore be useful in treating T. asahii fungemia, especially in patients receiving antiepileptic agents.
侵袭性毛孢子菌病是一种罕见且致命的真菌感染，发生于免疫功能低下的患者。在接受棘白菌素类药物治疗的患者中可能会出现突破性毛孢子菌病，因为毛孢子菌属对这些抗真菌药物具有耐药性。我们报告了一例突破性近平滑念珠菌菌血症。一名 62 岁日本女性因复发滤泡性淋巴瘤，在再诱导化疗期间出现间歇性发热，经验性地接受了广谱抗生素和米卡芬净治疗。在进行了四个周期的抗癌化疗后，她出现高热性中性粒细胞减少症，随后从血培养中检出近平滑念珠菌。由于卡马西平的使用禁忌，该患者不能使用伏立康唑，她成功地接受了氟康唑联合脂质体两性霉素 B 治疗，没有出现任何严重并发症。因此，氟康唑和脂质体两性霉素 B 的联合治疗可能对治疗近平滑念珠菌菌血症有用，尤其是在接受抗癫痫药物治疗的患者中。
