[Nosocomial infection due to Trichosporon asahii in a critical burned patient]

Rev Iberoam Micol. 2015 Oct-Dec;32(4):257-60. doi: 10.1016/j.riam.2014.07.005. Epub 2014 Nov 20.
[Article in Spanish]

Abstract

Background: Invasive fungal infection is an important cause of morbimortality in patients with severe burns. The advances in burn care therapy have considerably extended the survival of seriously burned patients, exposing them to infectious complications, notably fungal infections, with increased recognition of invasive infections caused by Candida species. However, some opportunistic fungi, like Trichosporon asahii, have emerged as important causes of nosocomial infection.

Case report: A case of nosocomial infection due to T. asahii in a severely ill burned patient successfully treated with voriconazole is presented. The management of invasive fungal infections in burned patients, from diagnosis to selection of the therapeutic protocol, is often a challenge. Early diagnosis and treatment are associated with a better prognosis. In this case report, current treatment options are discussed, and a review of previously published cases is presented.

Conclusions: Due to the difficulty in the diagnosis of invasive mycoses and their high associated mortality rates, it is advisable to keep a high degree of clinical suspicion of trichosporonosis in susceptible patients, including burned patients. The isolation of T. asahii in clinical specimens of this type of host must raise clinical alert, since it may precede an invasive infection.

Keywords: Antifungals; Antifúngicos; Burned; Critically ill patient; Emergent pathogen; Paciente crítico; Patógeno emergente; Quemado; Trichosporon asahii; Trichosporonosis.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Accidents, Occupational
  • Antifungal Agents / therapeutic use
  • Burns / complications*
  • Burns / microbiology
  • Candidiasis / complications
  • Caspofungin
  • Catheterization, Central Venous
  • Coinfection
  • Cross Infection / drug therapy
  • Cross Infection / etiology
  • Cross Infection / microbiology*
  • Ear, External / injuries
  • Ear, External / microbiology
  • Echinocandins / therapeutic use
  • Enterobacteriaceae Infections / complications
  • Female
  • Humans
  • Immunocompromised Host
  • Lipopeptides
  • Middle Aged
  • Morganella morganii / isolation & purification
  • Opportunistic Infections / drug therapy
  • Opportunistic Infections / etiology
  • Opportunistic Infections / microbiology*
  • Respiration, Artificial
  • Shock, Septic / etiology
  • Trichosporon / isolation & purification*
  • Trichosporonosis / diagnosis
  • Trichosporonosis / drug therapy
  • Trichosporonosis / etiology
  • Trichosporonosis / microbiology*
  • Voriconazole / therapeutic use
  • Wound Infection / drug therapy
  • Wound Infection / microbiology*

Substances

  • Antifungal Agents
  • Echinocandins
  • Lipopeptides
  • Caspofungin
  • Voriconazole