Tashiro T, Nagai H, Yamasaki T, Goto Y, Akizuki S, Nasu M
Second Department of Internal Medicine, Oita Medical University.
Kansenshogaku Zasshi. 1993 Aug;67(8):704-11. doi: 10.11150/kansenshogakuzasshi1970.67.704.
Trichosporon beigelii (formerly called Trichosporon cutaneum) is an emerging pathogen of disseminated trichosporonosis in immunocompromised patients. We conducted postmortem microbiological examinations of lung aspirates and blood in the heart. T. beigelii was isolated from the samples of 7 (2.24%) of 313 patients. Five of 7 patients isolated were diagnosed as having trichosporonosis based on histochemical and clinical findings. The other two were considered as colonization. Immunohistochemical study using Cryptococcus neoformans-absorbed antiserum to T. beigelii was carried out on the sections of autopsied tissues with deep mycoses. The sections from seven patients were positively stained, which were formerly diagnosed as candidiasis and/or aspergillosis. Consequently, 9 patients had disseminated trichosporonosis caused by T. beigelii. In Japan, 43 patients including the present 9, 31 males and 12 females, aged 51 (range, 2-84), were reported in the literature. Thirty-seven (86%) patients had hematologic malignancy, and the majority of them revealed profound neutropenia due to cytotoxic chemotherapy. Thirty-eight (88%) patients died despite the anti-fungal chemotherapy including amphotericin B. New strategies for refractory disseminated trichosporonosis in immunocompromised patients is needed.
白吉利丝孢酵母（以前称为皮肤丝孢酵母）是免疫功能低下患者播散性丝孢酵母病的一种新兴病原体。我们对肺吸出物和心脏血液进行了尸检微生物学检查。在313例患者的样本中，有7例（2.24%）分离出了白吉利丝孢酵母。根据组织化学和临床检查结果，7例分离出该菌的患者中有5例被诊断为患有丝孢酵母病。另外2例被认为是定植。使用针对白吉利丝孢酵母的新型隐球菌吸收抗血清对深部真菌病尸检组织切片进行免疫组织化学研究。7例患者的切片呈阳性染色，这些患者以前被诊断为念珠菌病和/或曲霉病。因此，有9例患者患有由白吉利丝孢酵母引起的播散性丝孢酵母病。在日本，文献报道了包括目前这9例患者在内的43例患者，其中男性31例，女性12例，年龄51岁（范围2 - 84岁）。37例（86%）患者患有血液系统恶性肿瘤，其中大多数因细胞毒性化疗而出现严重中性粒细胞减少。尽管使用了包括两性霉素B在内的抗真菌化疗，仍有38例（88%）患者死亡。免疫功能低下患者难治性播散性丝孢酵母病需要新的治疗策略。
