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Nr. 12(3)/2008
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Trichosporon asahii fungaemia in an adult patient with acute lymphoblastic leukaemia and viral hepatitis C. A Case Report

Annamária Földes, Doina-Veronica Bilca, Judit Beáta Köpeczi, Erzsébet Benedek, István Benedek, Enikő Farkas, Edit Székely


Abstract:

T. asahii is an emerging fungal pathogen that causes severe invasive diseases, particularly in immunocompromised hosts. We report the case of a 45-year-old woman T.M. who was first diagnosed with non-Hodgkin’s lymphoma (NHL) with B cells, but later pre-B acute lymphoblastic leukaemia (ALL) and viral hepatitis C were confirmed. After conventional cytostatic chemotherapy the patient achieved only partial haematological remission and she developed two periods of severe marrow aplasia. During the second period she became severely ill, with high fever (38-39C), and we isolated T. asahii from three sets of consecutive blood culture. The identification of the fungus was based on culture and microscopic characteristics, urease production and confirmed by using API Candida (BioMérieux) and Vitek 2 Compact System. The patient became afebrile after 12 days of antifungal therapy (6 days of fluconazole followed by voriconazole) associated with antibiotic therapy. Severe marrow aplasia persisted and her general condition deteriorated progressively. After 5 days of afebrility she developed signs of an acute abdominal syndrome and died of cardiac arrest. Invasive trichosporonosis should not be overlooked, particularly in neutropenic febrile patients with acute leukaemia; those received aggressive cytostatic and broad-spectrum antibiotic therapy. This case suggests the importance of identification and antifungal susceptibility testing of T. asahii for the application of an adequate treatment.

Keywords: Trichosporon asahii,blood culture,severe marrow aplasia,imunodepression,voriconazole

 
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How to cite
Földes A, Bilca DV, Köpeczi JB, Benedek E, Benedek I, Farkas E, et al. Trichosporon asahii fungaemia in an adult patient with acute lymphoblastic leukaemia and viral hepatitis C. A Case Report. Rev Romana Med Lab. 2008;12(3):37-45