Current Fungal Infection Reports

, Volume 4, Issue 1, pp 52–58 | Cite as

Trichosporon Infection

  • Jose A. Vazquez


Yeast exist throughout nature in association with soil, plants, mammals, and fish. As a result of this continued exposure, all humans are exposed to many different types of yeast through a variety of different routes. Recently, because of the increased population of immunocompromised patients and the extensive use of different antifungals, the incidence of infections due to non-Candida yeast has increased. Of these classic “nonpathogenic” yeast, Trichosporon species have been increasingly described producing deep-seated and disseminated infections that are difficult to predict and diagnose. In addition, the different species of Trichosporon have been found to be less susceptible or resistant to commonly used antifungals. Because of this intrinsic variation in antifungal susceptibility and the fact that these infections are generally seen in severely immunocompromised hosts, they are associated with significant morbidity and mortality, despite their known “nonpathogenic” characteristics described in superficial infections.


Trichosporon infections Yeast Immunocompromised Antifungal Disseminated trichosporonosis 



Dr. Vazquez has received grants from and been a speaker for Pfizer; has been a speaker and consultant for Astellas; and has received grants from Merck.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. 1.
    Safdar A, Singhal S, Mehta J: Clinical significance of non-Candida fungal blood isolation in patients undergoing high-risk allogeneic hematopoietic stem cell transplantation (1993–2001). Cancer 2004, 100:2456–2461.CrossRefPubMedGoogle Scholar
  2. 2.
    • Kontoyiannis DP: Echinocandin-based initial therapy in fungemic patients with cancer: a focus on recent guidelines of the Infectious Diseases Society of America. Clin Infect Dis 2009, 49:638–640. This article discusses the possible increase in infections or breakthrough infections with echinocandin-resistant fungi such as Trichosporon species in an era when echinocandins appear to be the drugs of choice in most infections caused by “yeast.” Google Scholar
  3. 3.
    •• Chagas-Neto TC, Chaves GM, Colombo AL: Update on the genus Trichosporon. Mycopathologia 2008, 166:121–132. This article provides an excellent overview of the genus Trichosporon, including microbiology, clinical manifestation, MICs, and therapeutic options.Google Scholar
  4. 4.
    Watson KC, Kallichurum S: Brain abscess due to Trichosporon cutaneum. J Med Microbiol 1970, 3:191–193.CrossRefPubMedGoogle Scholar
  5. 5.
    Behrend G: Ubertrichomycosis nodosa. Berlin Lin Wochenschr 1890, 27:464.Google Scholar
  6. 6.
    Kwon-Chung KJ, Bennett JE: Infections due to Trichosporon and other miscellaneous yeast-like fungi. In Medical Mycology. Edited by Kwon-Chung KJ, Bennett JE. Philadelphia: Lea & Febiger; 1992:768–782.Google Scholar
  7. 7.
    Rippon JW: Superficial infections. In Medical Mycology: The Pathogenic Fungi and the Pathogenic Actinomycetes. Edited by Rippon JW. Philadelphia: WB Saunders; 1988:154–168.Google Scholar
  8. 8.
    Gueho E, de Hoog GS, Smith MT, Meyer SA: DNA relatedness, taxonomy, and medical significance of Geotrichum capitatum. J Clin Microbiol 1997, 25:1191–1194.Google Scholar
  9. 9.
    Salkin IF, Gordon MA, Samsonoff WA, Rieder CL: Blastoschizomyces capitatus, a new combination. Mycotaxon 1985, 22:375–380.Google Scholar
  10. 10.
    Kemeker BJ, Lehman PF, Lee JW, Walsh TJ: Distinction of deep vs. superficial clinical and non-clinical environmental isolates of Trichosporon beigelii by isoenzymes and restriction fragment length polymorphisms of rDNA generated by the polymerase chain reaction. J Clin Microbiol 1991, 29:1677–1683.Google Scholar
  11. 11.
    Ramos JM, Cuenca-Estrella M, Gutierrez F, et al.: Clinical case of endocarditis due to Trichosporon inkin and antifungal susceptibility profile of the organism. J Clin Microbiol 2004, 42:2341–2344.CrossRefPubMedGoogle Scholar
  12. 12.
    Hickey PW, Sutton DA, Fothergill AW, et al.: Trichosporon mycotoxinivorans, a novel respiratory pathogen in patients with cystic fibrosis. J Clin Microbiol 2009, 47:3091–3097.CrossRefPubMedGoogle Scholar
  13. 13.
    Seeliger HPR, Schroter R: A serologic study on the antigenic relationship of the form genus Trichosporon. Sabouraudia 1963, 2:248–250.Google Scholar
  14. 14.
    Campbell CK, Payne AL, Teall AJ, et al.: Cryptococcal latex antigen test positive in a patient with Trichosporon beigelii. Lancet 1985, 2:43–44.CrossRefPubMedGoogle Scholar
  15. 15.
    McManus EJ, Bozdech MJ, Jones JM: Role of the latex agglutination test for cryptococcal antigen in diagnosing disseminated infection with Trichosporon beigelii. J Infect Dis 1985, 151:1167–1169.PubMedGoogle Scholar
  16. 16.
    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
  17. 17.
    Haupt HM, Merz WG, Beschorner WE, et al.: Colonization and infection with Trichosporon species in the immunosuppressed host. J Infect Dis 1983, 147:199–203.PubMedGoogle Scholar
  18. 18.
    Rose HD, Kurup VP: Colonization of hospitalized patients with yeast-like organisms. Sabouraudia 1977, 15:251–256.PubMedGoogle Scholar
  19. 19.
    Ebright JR, Fairfax MR, Vazquez JA: Trichosporon asahii, a non-Candida yeast that caused fatal septic shock in a patient without cancer or neutropenia. Clin Infect Dis 2001, 33:28–30.CrossRefGoogle Scholar
  20. 20.
    Krcmery V, Mateicka F, Kunova A, et al.: Hematogenous trichosporonosis in cancer patients: report of 12 cases including 5 during prophylaxis with itraconazole. Support Care Cancer 1999, 7:39–43.CrossRefPubMedGoogle Scholar
  21. 21.
    Keay S, Denning D, Stevens DA: Endocarditis due to Trichosporon beigelii: in vitro susceptibility of isolates and review. Rev Infect Dis 1991, 13:383–386.PubMedGoogle Scholar
  22. 22.
    Fisher DJ, Christy C, Spafford P, et al.: Neonatal Trichosporon beigelii infection. Report of a cluster of cases in a neonatal intensive care unit. Pediatr Infect Dis J 1993, 12:149–155.PubMedCrossRefGoogle Scholar
  23. 23.
    Mirza SH: Disseminated Trichosporon beigelii infection causing skin lesions in a renal transplant patient. J Infect 1993, 27:67–70.CrossRefPubMedGoogle Scholar
  24. 24.
    Hajjeh RA, Blumberg HM: Bloodstream infection due to Trichosporon beigelii in a burn patient: case report and review of therapy. Clin Infect Dis 1995, 20:913–916.PubMedGoogle Scholar
  25. 25.
    Lussier N, Laverdiere M, Delorme J, et al.: Trichosporon beigelii funguria in renal transplant recipients. Clin Infect Dis 2000, 31:1299–1301.CrossRefPubMedGoogle Scholar
  26. 26.
    Chan RM, Lee P, Wroblewski J: Deep-seated trichosporonosis in an immunocompetent patient: a case report of uterine tricho-sporonosis. Clin Infect Dis 2000, 31:621–625.CrossRefPubMedGoogle Scholar
  27. 27.
    • Netsvyetayeva I, Swoboda-Kopec E, Paczek L, et al.: Trichosporon asahii as a prospective pathogen in solid organ transplant recipients. Mycoses 2009, 52:263–265. This article describes the importance of other fungi, especially the increased prevalence of T. asahii in solid organ transplantation instead of infections due to the classic Candida and Aspergillus species.Google Scholar
  28. 28.
    •• 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–e17. This article provides a general review of Trichosporon species and clinical characteristics.Google Scholar
  29. 29.
    Da Silva Rodrigues G, Ubatuba de Faria RR, Silva Guazzelli L, et al.: Infeccion nosocomial por Trichosporon asahii:revision clinica de 22 casos. Rev Iberoam Micol 2006, 23:85–89.Google Scholar
  30. 30.
    Marin J, Chiner E, Franco J, Borras R: Trichosporon beigelii pneumonia in a neutropenic patient. Eur J Clin Microbiol Infect Dis 1989, 8:631–633.CrossRefPubMedGoogle Scholar
  31. 31.
    Cheng IKP, Fang G, Chan T, et al.: Fungal peritonitis complicating peritoneal dialysis: report of 27 cases and review of the literature. Q J Med 1989, 71:407–416.PubMedGoogle Scholar
  32. 32.
    Sheikh HA, Mahgoub S, Badi K: Postoperative endophthalmitis due to Trichosporon cutaneum. Brit J Ophthalmol 1986, 58:591–594.CrossRefGoogle Scholar
  33. 33.
    Bhansali S, Karanes K, Palutke W, et al.: Successful treatment of disseminated Trichosporon beigelii (cutaneum) infection with associated splenic involvement. Cancer 1986, 58:1630–1632.CrossRefPubMedGoogle Scholar
  34. 34.
    Szili M, Domjan L: Primary gastric mycosis caused by Trichosporon cutaneum. Mykosen 1982, 25:189–193.PubMedGoogle Scholar
  35. 35.
    Patel SA, Borges MC, Batt MD, Rosenblate HJ: Trichosporon cholangitis associated with hyperbilirubinemia, and findings suggesting primary sclerosing cholangitis on endoscopic retrograde cholangiopancreatography. Gastroenterology 1990, 85:84–87.Google Scholar
  36. 36.
    Surmont I, Vergauwen B, Marcelis L, et al.: First report of chronic meningitis caused by Trichosporon beigelii. Eur J Clin Microbiol Infect Dis 1990, 9:226–229.CrossRefPubMedGoogle Scholar
  37. 37.
    Walsh TJ, Melcher GP, Rinaldi MG, et al.: Trichosporon beigelii, an emerging pathogen resistant to amphotericin B. J Clin Microbiol 1990, 28:1616–1622.PubMedGoogle Scholar
  38. 38.
    Yung CW, Hanauer SB, Fretzin D, et al.: Disseminated Trichosporon beigelii (cutaneum). Cancer 1981, 48:2107–2111.CrossRefPubMedGoogle Scholar
  39. 39.
    Walsh TJ, Orth DH, Shapiro CM, Levine RA: Metastatic fungal chorioretinitis developing during Trichosporon sepsis. Ophthalmology 1982, 89:152–156.PubMedGoogle Scholar
  40. 40.
    Walsh TJ: Trichosporonosis. Infect Dis Clin North Am 1989, 3:43–52.PubMedGoogle Scholar
  41. 41.
    Walsh TJ, Newman KR, Moody M, et al.: Trichosporonosis in patients with neoplastic disease. Medicine (Baltimore) 1986, 65:268–279.CrossRefGoogle Scholar
  42. 42.
    Ito T, Ishikawa Y, Fujii R, et al.: Disseminated Trichosporon capitatum infection in a patient with acute leukemia. Cancer 1988, 61:585–588.CrossRefPubMedGoogle Scholar
  43. 43.
    Mochizuki T, Sugiura H, Watanabe S, et al.: A case of disseminated trichosporonosis: a case report and immunohistochemical identification of fungal elements. J Med Vet Mycol 1988, 26:343–349.CrossRefPubMedGoogle Scholar
  44. 44.
    Liu KL, Herbrecht R, Bergerat JP, et al.: Disseminated Trichosporon capitatum infection in a patient with acute leukemia undergoing bone marrow transplantation. Bone Marrow Transplant 1990, 6:219–221.PubMedGoogle Scholar
  45. 45.
    Thaler M, Pastakia B, Shawker TH, et al.: Hepatic candidiasis in cancer patients: the evolving picture of the syndrome. Ann Intern Med 1988, 108:88–100.PubMedGoogle Scholar
  46. 46.
    Meyer MH, Letscher-Bru V, Waller J, et al.: Chronic disseminated Trichosporon asahii infection in a leukemic child. Clin Infect Dis 2002, 35:e22–e25.CrossRefPubMedGoogle Scholar
  47. 47.
    Serena C, Pastor FJ, Ortoneda M, et al.: In vitro antifungal susceptibilities of uncommon basidiomycetous yeasts. Antimicrob Agents Chemother 2004, 48:2724–2726.CrossRefPubMedGoogle Scholar
  48. 48.
    Pfaller MA, Diekema DJ: Rare and emerging opportunistic fungal pathogens: concerns for resistance beyond Candida albicans and Aspergillus fumigatus. J Clin Microbiol 2004, 42:4419–4431.CrossRefPubMedGoogle Scholar
  49. 49.
    Pfaller MA, Diekema DJ, Gibbs DL, et al.: Results from the ARTEMIS DISK global antifungal surveillance study, 1997 to 2007: 10.5-year analysis of susceptibilities of noncandidal yeast species to fluconazole and voriconazole determined by CLSI standardized disk diffusion testing. J Clin Microbiol 2009, 47:117–123.CrossRefPubMedGoogle Scholar
  50. 50.
    Thompson GR, Wiederhold NP, Sutton DA, et al.: In vitro activity of isavuconazole against Trichosporon, Rhodutorula, Geotrichum, Saccharomyces and Pichia species. J Antimicrob Chemother 2009, 64:79–83.CrossRefPubMedGoogle Scholar
  51. 51.
    Walsh TJ, Lee JW, Melcher GP, et al.: Experimental Trichosporon infection in persistently granulocytopenic rabbits: implications for pathogenesis, diagnosis, and treatment of an emerging opportunistic mycosis. J Infect Dis 1992, 166:121–133.PubMedGoogle Scholar
  52. 52.
    Paphitou NI, Ostrosky-Zeichner L, Paetznick VL, et al.: In vitro antifungal susceptibilities of Trichosporon species. Antimicrob Agents Chemother 2002, 46:1144–1146.CrossRefPubMedGoogle Scholar
  53. 53.
    Anaissie E, Gokaslan A, Hachem R, et al.: Azole therapy for trichosporonosis: clinical evaluation of eight patients, experimental therapy for murine infection, and review. Clin Infect Dis 1992, 15:781–787.PubMedGoogle Scholar
  54. 54.
    Matsue K, Uryu H, Koseki M, et al.: Breakthrough trichosporonosis in patients with hematologic malignancies receiving micafungin. Clin Infect Dis 2006, 42:753–757.CrossRefPubMedGoogle Scholar
  55. 55.
    Mazuelos EM, Rodriguez-Tudela JL: Actividad in vitro de anidulafungina. Comparacion con actividad de otras equinocandinas. Enferm Infecc Microbiol Clin 2008, 26:7–13.CrossRefGoogle Scholar
  56. 56.
    Serena C, Pastor FJ, Gilgado F, et al.: Efficacy of micafungin in combination with other drugs in a murine model of disseminated trichosporonosis. Antimicrob Agents Chemother 2005, 49:497–502.CrossRefPubMedGoogle Scholar
  57. 57.
    Goodman D, Pamer E, Jakubowski A, et al.: Breakthrough trichosporonosis in a bone marrow transplant recipient receiving caspofungin acetate. Clin Infect Dis 2002, 35:e35–e36.CrossRefPubMedGoogle Scholar
  58. 58.
    Wolf DG, Falk R, Hacham M, et al.: Multidrug-resistant Trichosporon asahii infection of nongranulocytopenic patients in three intensive care units. J Clin Microbiol 2001, 39:4420–4425.CrossRefPubMedGoogle Scholar
  59. 59.
    Gemeinhardt H: Lungenpathogenitat von Trichosporon capitatum beim menschen. Zentrablatt fur Bakteriolgie (Series A) 1965, 196:121–133.Google Scholar
  60. 60.
    Martino P, Venditti M, Micozzi A, et al.: Blastoschizomyces capitatus: an emerging cause of invasive fungal disease in leukemia patients. Rev Infect Dis 1990, 12:570–582.PubMedGoogle Scholar
  61. 61.
    D’Antonio D, Piccolomini R, Fioritoni G, et al.: Osteomyelitis and intervertebral discitis caused by Blastoschizomyces capitatus in a patient with acute leukemia. J Clin Microbiol 1994, 32:224–227.PubMedGoogle Scholar
  62. 62.
    Espinel-Ingroff A: Comparison of in vitro activities of the new triazole SCH56592 and the echinocandins MK-0991 (L-743,872) and LY303366 against opportunistic filamentous and dimorphic fungi and yeast. J Clin Microbiol 1998, 36:2950–2956.PubMedGoogle Scholar
  63. 63.
    Polacheck I, Salkin IF, Kitzes-Cohen R, Raz R: Endocarditis caused by Blastoschizomyces capitatus and taxonomic review of the genus. J Clin Microbiol 1992, 30:2318–2322.PubMedGoogle Scholar
  64. 64.
    Hazen KC: New and emerging yeast pathogens. Clin Microbiol Rev 1995, 8:462–478.PubMedGoogle Scholar
  65. 65.
    Espinel-Ingroff A: In vitro activity of the new triazole voriconazole (UK-109,496) against opportunistic filamentous and dimorphic fungi and common and emerging yeast pathogens. J Clin Microbiol 1998, 36:198–202.PubMedGoogle Scholar

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© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  1. 1.Division of Infectious DiseasesHenry Ford HospitalDetroitUSA
  2. 2.School of MedicineWayne State UniversityDetroitUSA

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