Mycopathologia

, Volume 181, Issue 3–4, pp 285–290 | Cite as

Subcutaneous Infection Associated with Trichosporon ovoides: A Case Report and Review of Literature

  • Ratna Mohd Tap
  • Parameswari Sabaratnam
  • Nur Yasmin Ramli
  • Rohaidah Hashim
  • Abd Razak Mohd Fuat
  • Pey Peng Ng
  • Husna Khairam
  • Norazah Ahmad
Article

Abstract

Trichosporon species are opportunistic yeasts which can cause infections, especially in immunocompromised patients. This is a report of Trichosporon ovoides that caused subcutaneous infection in a patient with underlying ischemic heart disease. The identification of fungal isolate was confirmed by PCR sequencing of ITS and large subunit regions in rRNA gene. In vitro susceptibility study showed that the isolate was susceptible to amphotericin B, fluconazole and voriconazole, and resistant to caspofungin, anidulafungin and itraconazole. The lesion improved after treatment with oral fluconazole and topical miconazole.

Keywords

Trichosporon ovoides Trichosporonosis Subcutaneous infection 

Notes

Acknowledgments

The authors would like to thank the Director General of Health, Malaysia, and the Director of IMR for permission to publish this article. We would also like to acknowledge the Department of Pathology, Sultanah Bahiyah Hospital, Alor Setar, Kedah, Malaysia, for providing the yeast isolate.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Standard

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

References

  1. 1.
    Walsh TJ, Melcher GP, Lee JW, Pizzo PA. Infections due to Trichosporon species: new concepts in mycology, pathogenesis, diagnosis and treatment. Curr Top Med Mycol. 1993;5:79–113.PubMedGoogle Scholar
  2. 2.
    Pritchard RC, Muir DB. Trichosporon beigelii: survey of isolates from clinical material. Pathology. 1985;17:20–3.CrossRefPubMedGoogle Scholar
  3. 3.
    Li HM, Hong-Tao D, Wei L, Zhe W, Li RY. Microbiological characteristics of medically important Trichosporon species. Mycopathologia. 2005;160:217–25.CrossRefPubMedGoogle Scholar
  4. 4.
    Chagas-Neto TC, Chaves GM, Columbo AL. Update on genus. Trichosporon Mycopathol. 2008;166:121–32.CrossRefGoogle Scholar
  5. 5.
    Arikan S, Hascelik G. Comparison of NCCLS microdilution method and E-test in antifungal susceptibility testing of clinical Trichosporon asahii isolates. Diagn Microbiol Infect. 2002;43:107–11.CrossRefGoogle Scholar
  6. 6.
    White TJ, Bruns T, Lee S, Taylor J. Amplification and direct sequencing of fungal ribosomal RNA genes for phylogenetics. In: Innis MA, Gelfand DH, Sninsky JJ, White TJ, editors. PCR protocols: a guide to methods and applications. San Diego: Academic; 1990. p. 315–22.Google Scholar
  7. 7.
    O’Donnell K. Fusarium and its near relatives. In: Reynolds DR, Taylor JW, editors. The fungal holomorph: mitotic, meiotic and pleomorphic speciation in fungal systematics. Wallingford: CAB International; 1993. p. 225–33.Google Scholar
  8. 8.
    Tap TM, Sabaratnam P, Ahmad NA, Abd Razak MF, Hashim R, Ahmad N. Chaetomium globosum cutaneous fungal infection confirmed by molecular identification: a case report from Malaysia. Mycopathologia. 2015;180(1):137–41.Google Scholar
  9. 9.
    Gueho E, de Hoog GS, Smith MT. Neotypification of the genus Trichosporon. Antonie Van Leeuwenhoek. 1992;61(4):285–8.CrossRefPubMedGoogle Scholar
  10. 10.
    Sugita T, Nishikawa A, Shinoda T. Reclassification of Trichosporon cutaneum by DNA relatedness by using the spectrophotometric method and chemiluminometric method. J Gen Appl Microbiol. 1994;40:397–408.CrossRefGoogle Scholar
  11. 11.
    Sugita T, Nishikawa A, Shinoda T, Kume H. Taxonomic position of deep-seated, mucosa-associated, and superficial isolates of Trichosporon cutaneum from trichosporonosis patients. J Clin Microbiol. 1995;33(5):1368–70.PubMedPubMedCentralGoogle Scholar
  12. 12.
    Rodriguez-Tudela JL, Diaz-Guerra TM, Mellado E, et al. Susceptibility patterns and molecular identification of Trichosporon species. Antimicrob Agents Chemother. 2005;49:4026–34.CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Sugita T, Makimura K, Nishikawa A, Uchida K, Yamaguchi H, Shinoda T. Partial sequences of large subunit ribosomal DNA of a new yeast species, Trichosporon domesticum, and related species. Microbiol Immunol. 1997;41:571–3.CrossRefPubMedGoogle Scholar
  14. 14.
    Sugita T, Nishikawa A, Shinoda T. Identification of Trichosporon asahii by PCR based on sequences of the internal transcribed spacer regions. J Clin Microbiol. 1998;36:2742–4.PubMedPubMedCentralGoogle Scholar
  15. 15.
    Sugita T, Nakajima M, Ikeda R, Matsushima T, Shinoda T. Sequence analysis of the ribosomal DNA intergenic spacer 1 regions of Trichosporon species. J Clin Microbiol. 2002;40:1826–30.CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Ruan SY, Chien JY, Hsueh PR. Invasive trichosporonosis caused by Trichosporon asahii and other unusual Trichosporon species at a Medical Center in Taiwan. Clin Infect Dis. 2009;49:e11–7.CrossRefPubMedGoogle Scholar
  17. 17.
    Sugita T, Nishikawa A, Ikeda R, Shinoda T. Identification of medically relevant Trichosporon species based on sequences of internal transcribed spacer regions and construction of a database for Trichosporon identification. J Clin Microbiol. 1999;37:1985–93.PubMedPubMedCentralGoogle Scholar
  18. 18.
    Koyanagi T, Nishida N, Osabe S, Imamura Y, Yamamoto S, Shichiji A, Nakamura Y. Autopsy case of disseminated Trichosporon inkin infection identified with molecular biological and biochemical methods. Pathol Int. 2006;56:738–43.CrossRefPubMedGoogle Scholar
  19. 19.
    Nakajima M, Sugita T, Mikami Y. Granuloma associated with Trichosporon asahii infection in the lung: unusual pathological findings and PCR detection of Trichosporon DNA. Med Mycol. 2007;45:641–4.CrossRefPubMedGoogle Scholar
  20. 20.
    Hsiue HC, Huang YT, Kuo YL, Liao CH, Chang TC, Hsueh PR. Rapid identification of fungal pathogens in positive blood cultures using oligonucleotide array hybridization. Clin Microbiol Infect. 2010;16:493–500.CrossRefPubMedGoogle Scholar
  21. 21.
    Hahner D, Kirschner R, Piepenbring M, Schöfer H. First isolation of the anamorphic basidiomycetous yeast Trichosporon faecale in Germany, from the skin of a patient. Mycopathologia. 2008;165:149–53.CrossRefPubMedGoogle Scholar
  22. 22.
    Nagai H, Yamakami Y, Hashimoto A, Tokimatsu I, Nasu M. PCR detection of DNA specific for Trichosporon species in serum of patients with disseminated trichosporonosis. J Clin Microbiol. 1999;37:694–9.PubMedPubMedCentralGoogle Scholar
  23. 23.
    Schoch CL, Seifert KA, Huhndorf S, Robert V, Spouge JL, Levesque CA, Chen W. Nuclear ribosomal internal transcribed spacer (ITS) region as a universal DNA barcode marker for Fungi. Proc Natl Acad Sci USA. 2012;109:6241–6.CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    Miceli MH, Díaz JA, Lee SA. Emerging opportunistic yeast infections. Lancet Infect Dis. 2011;11:142–51.CrossRefPubMedGoogle Scholar
  25. 25.
    Biswas SK, Wang L, Yokoyama K, Nishimura K. Molecular phylogenetics of the genus Trichosporon inferred from mitochondrial cytochrome b gene sequences. J Clin Microbiol. 2005;43:5171–8.CrossRefPubMedPubMedCentralGoogle Scholar
  26. 26.
    Sugita T, Nakase T. Molecular phylogenetic study of the basidiomycetous anamorphic yeast genus Trichosporon and related taxa based on small subunit ribosomal DNA sequences. Mycoscience. 1998;39:7–13.CrossRefGoogle Scholar
  27. 27.
    MagalhãesI AR, de Mondino SSB, da Silva M, Nishikawa MM. Morphological and biochemical characterization of the aetiological agents of white piedra. Mem Inst Oswaldo Cruz Rio de Janeiro. 2008;103(8):786–90.CrossRefGoogle Scholar
  28. 28.
    Gueho E, de Hoog GS, Smith MT. Neotypification of the genus Trichosporon. Antonie Van Leeuwenhoek. 1992;61:285–8.CrossRefPubMedGoogle Scholar
  29. 29.
    Gueho E, Improvisi L, de Hoog GS, Dupont B. Trichosporon on humans: a practical account. Mycoses. 1994;37:3–10.CrossRefPubMedGoogle Scholar
  30. 30.
    Tambe SA, Dhurat SR, Kumar CA, Thakare P, Lade N, Jerajani H, et al. Two cases of scalp white piedra caused by Trichosporon ovoides. Indian J Dermatol Venereol Leprol. 2009;75:293–5.CrossRefPubMedGoogle Scholar
  31. 31.
    Sugita T, Nishikawa A, Shinoda T, Kume H. Taxonomic position of deep-seated, mucosa-associated and superficial isolates of Trichosporon cutaneum from trichosporonosis patients. J Clin Microbiol. 1995;33:1368–70.PubMedPubMedCentralGoogle Scholar
  32. 32.
    Sugita T, Nishikawa A, Shinoda T. Rapid detection of species of the opportunistic yeast Trichosporon by PCR. J Clin Microbiol. 1998;6:1458–60.Google Scholar
  33. 33.
    Sugita T, Ikeda R, Nishikawa A. Analysis of Trichosporon isolates obtained from the houses of patients with summer-type hypersensitivity pneumonitis. J Clin Microbiol. 2004;42:5467–71.CrossRefPubMedPubMedCentralGoogle Scholar
  34. 34.
    Cho CG, Kye YC, Kim SN. A case of Subcutaneous infection with Trichosporon cutaneum in a kidney transplanted patient. Korean J Med Mycol. 1998;3(1):58–61.Google Scholar
  35. 35.
    Ramos JM, Cuenca-Estrella M, Gutierrez F, Elia M, Rodriguez-Tudela JL. Clinical case of endocarditis due to Trichosporon inkin and antifungal susceptibility profile of the organism. J Clin Microbiol. 2004;42:2341–4.CrossRefPubMedPubMedCentralGoogle Scholar
  36. 36.
    Song HJ, Chung SL, Lee KS. Trichosporon inkin subcutaneous infection in a rheumatoid arthritis patient. Int J Dermatol. 2007;46:282–3.CrossRefPubMedGoogle Scholar
  37. 37.
    Colombo AL, Padovan AC, Chaves GM. Current knowledge of Trichosporon spp. and trichosporonosis. Clin Microbiol Rev. 2011;24(4):682–700.CrossRefPubMedPubMedCentralGoogle Scholar
  38. 38.
    Lemes RML, Lyon JP, Moreira LM, de Resende MA. Antifungal susceptibility profile of Trichosporon isolates: correlation between CLSI and E-test methodologies. Braz J Microbiol. 2010;41:310–5.CrossRefPubMedPubMedCentralGoogle Scholar
  39. 39.
    Chagas-Neto TC, Chaves GM, Melo ASA, Colombo AL. Bloodstream infections due to Trichosporon spp.: species distribution, Trichosporon asahii genotypes determined on the basis of ribosomal DNA intergenic spacer 1 sequencing, and antifungal susceptibility testing. J Clin Microbiol. 2009;47:1074–81.CrossRefPubMedPubMedCentralGoogle Scholar
  40. 40.
    Taj-Aldeen SJ, Al-Ansari N, El Shafei S, Meis JF, Curfs-Breuker I, Theelen B, et al. Molecular identification and susceptibility of Trichosporon species isolated from clinical specimens in Qatar: isolation of Trichosporon dohaense Taj-Aldeen, Meis & Boekhout sp. J Clin Microbiol. 2009;47(6):1791–9.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Science+Business Media Dordrecht 2015

Authors and Affiliations

  • Ratna Mohd Tap
    • 1
  • Parameswari Sabaratnam
    • 1
  • Nur Yasmin Ramli
    • 1
  • Rohaidah Hashim
    • 1
  • Abd Razak Mohd Fuat
    • 1
  • Pey Peng Ng
    • 2
  • Husna Khairam
    • 2
  • Norazah Ahmad
    • 1
  1. 1.Bacteriology Unit, Infectious Diseases Research CenterInstitute for Medical ResearchKuala LumpurMalaysia
  2. 2.Microbiology Unit, Pathology DepartmentSultanah Bahiyah HospitalAlor SetarMalaysia

Personalised recommendations