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Trichosporon asahii causing subcutaneous mycoses in an immunocompetent patient: case report and a minireview

  • Clinical Microbiology - Research Paper
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Abstract

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.

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Data availability

The data that support the findings of this report are available on request from the corresponding author S.S.G. The data are not publicly available as they contain information that could compromise patient privacy.

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Funding

This work received funds from the Fundação de Amparo à Pesquisa do Espírito Santo (FAPES) (process number: FAPES/ES 111/2017), and the National Council for Science and Technological Development (CNPq) provided a scholarship to F.A.L.

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Authors and Affiliations

  1. Hospital Universitário Cassiano Antônio de Moraes (HUCAM), Federal University of Espírito Santo (UFES), Vitoria, ES, Brazil

    Wdson Luis Lima Kruschewsky

  2. Hospital Infantil Nossa Senhora da Glória (HEINSG), Vitória, ES, Brazil

    Pedro Massaroni-Peçanha

  3. Center for Research in Medical Mycology, Department of Pathology, Federal University of Espírito Santo (UFES), Av. Marechal Campos, 1468, Vitoria, ES, 29040-090, Brazil

    Simone Bravim Maifrede & Sarah Santos Gonçalves

  4. Universidade de Alfenas (UNIFENAS), Belo Horizonte, MG, Brazil

    Marcelo Santos Leite

  5. University of Vila Velha (UVV), Hospital de Vila Velha, Vila Velha, ES, Brazil

    Tâmea Aparecida Linhares Pôssa

  6. Laboratório Alerta, Division of Infectious Diseases, Department of Internal Medicine, Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina (EPM), São Paulo, SP, Brazil

    Felipe Alberto-Lei & Rodrigo Cayô

  7. Laboratório de Imunologia E Microbiologia (LIB), Departamento de Ciências Biológicas (DCB), Universidade Federal de São Paulo (UNIFESP), Setor de Biologia Molecular, Microbiologia E Imunologia, Instituto de Ciências Ambientais, Químicas e Farmacêuticas (ICAQF), SP, Diadema, Brazil

    Rodrigo Cayô

  8. Section of Infectious Diseases, Department of Medicine, Hospital Universitário Cassiano Antônio de Moraes (HUCAM), Federal University of Espírito Santo (UFES), Vitoria, ES, Brazil

    Paulo Mendes Peçanha

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  1. Wdson Luis Lima Kruschewsky
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  2. Pedro Massaroni-Peçanha
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Contributions

WLLK: medical records review, data analysis, and manuscript preparation. PM-P: clinical assistance (infectious diseases) of the patient. SBM: manuscript preparation, phenotypic identification, and susceptibility testing. MSL: manuscript preparation and data analysis. TALP: clinical assistance (infectious diseases) of the patient. FAL: molecular identification of the fungal strains and data analysis. RC: main research coordinator, mycology laboratorial supervision, data analysis, mycology and molecular test supervision, and manuscript preparation. PMP: medical records review and clinical assistance (infectious diseases) of the patient. SSG: main research coordinator, mycology laboratorial supervision, data analysis, mycology and molecular test supervision, and manuscript preparation.

Corresponding author

Correspondence to Sarah Santos Gonçalves.

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Ethics approval

Ethical approval for this study was obtained from the Research Ethics Committee of the Federal University of Espírito Santo—UFES (process number: CAAE: 34278920.9.0000.5060).

Consent to participate

The patient consented to participate in the present report.

Consent for publication

The authors affirm that the patient provided informed consent for publication of the data and images.

Conflict of interest

The authors have nothing to declare. This study was not financially supported by any diagnostic/pharmaceutical company. This work was presented in part as a paper poster (70) at the 17th Infocus and 1st International Society of Human and Animal Mycology (ISHAM) conferences in Salvador, Brazil, in 2019.

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Wdson Luis Lima Kruschewsky and Pedro Massaroni-Peçanha contributed equally to this work.

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Kruschewsky, W.L.L., Massaroni-Peçanha, P., Maifrede, S.B. et al. Trichosporon asahii causing subcutaneous mycoses in an immunocompetent patient: case report and a minireview. Braz J Microbiol 53, 1221–1229 (2022). https://doi.org/10.1007/s42770-022-00737-x

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