Hospital Universitário Cassiano Antônio de Moraes (HUCAM), Federal University of Espírito Santo (UFES), Vitoria, ES, Brazil.
Hospital Infantil Nossa Senhora da Glória (HEINSG), Vitória, ES, Brazil.
Braz J Microbiol. 2022 Sep;53(3):1221-1229. doi: 10.1007/s42770-022-00737-x. Epub 2022 Apr 5.
Trichosporon spp. are a constituent of the normal flora of humans that can cause both superficial and invasive infections, mainly in immunocompromised and immunocompetent hosts, respectively. Herein, we a report of Trichosporon asahii causing subcutaneous fungal infection (SFI) in an immunocompetent patient after carpal tunnel surgery. Although susceptible to fluconazole, the treatment of SFI failed even using high doses of this azole. The skin lesion improved following the administration of voriconazole. We conducted a literature minireview searching reports on SFI in immunocompetent patients to check for epidemiological, diagnostic, therapeutic, and outcome characteristics. A total of 32 cases were reported. Despite being uncommon, the clinical suspicion and early diagnosis of SFI in immunocompetent patients undergoing previous surgery are important. Our study indicated that the azoles are the most active antifungal agents against Trichosporon spp., except for fluconazole, and voriconazole can be considered the first therapeutic option.
新生隐球菌是人类正常菌群的一部分，可分别引起免疫功能低下和免疫功能正常宿主的浅部和深部感染。在此，我们报告 1 例在腕管手术后免疫功能正常的患者发生新生隐球菌引起的皮下真菌感染（SFI）。尽管新生隐球菌对氟康唑敏感，但即使使用大剂量氟康唑治疗，SFI 仍未治愈。给予伏立康唑后，皮肤病变改善。我们进行了文献迷你综述，检索了免疫功能正常患者 SFI 的报告，以检查流行病学、诊断、治疗和结局特征。共报告了 32 例病例。尽管罕见，但对既往手术的免疫功能正常患者进行 SFI 的临床疑诊和早期诊断很重要。我们的研究表明，除氟康唑外，唑类药物是针对新生隐球菌最有效的抗真菌药物，伏立康唑可被视为首选治疗药物。
