Successful Treatment of Breakthrough Trichosporon asahii Fungemia by the Combination Therapy of Fluconazole and Liposomal Amphotericin B in a Patient with Follicular Lymphoma

Invasive trichosporonosis is a rare and lethal fungal infection that occurs in immunocompromised patients. Breakthrough trichosporonosis can occur in patients treated with echinocandins since Trichosporon spp. are resistant to these antifungal agents. We report a case of breakthrough Trichosporon as...

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Bibliographic Details
Published in:Mycopathologia (1975) 2021-03, Vol.186 (1), p.113-117
Main Authors: Itoh, Kazuhiro, Iwasaki, Hiromichi, Negoro, Eiju, Shigemi, Hiroko, Tokimatsu, Issei, Tsutani, Hiroshi, Yamauchi, Takahiro
Format: Article
Language:English
Subjects:
Amphotericin B
Antibiotics
Antiepileptic agents
Antifungal agents
Antiparasitic agents
Biomedical and Life Sciences
Blood
Blood cancer
Blood culture
Cancer
Carbamazepine
Care and treatment
Case reports
Chemotherapy
Combination therapy
Echinocandins
Eukaryotic Microbiology
Fever
Fluconazole
Fungemia
Health aspects
Immunocompromised hosts
Invasiveness
Life Sciences
Lymphoma
Lymphomas
Medical examination
Medical Microbiology
Micafungin
Microbial Ecology
Microbiology
Mycoses
Neutropenia
Patients
Plant Sciences
Short Communication
Tazobactam
Trichosporon asahii
Trichosporonosis
Voriconazole
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Summary:Invasive trichosporonosis is a rare and lethal fungal infection that occurs in immunocompromised patients. Breakthrough trichosporonosis can occur in patients treated with echinocandins since Trichosporon spp. are resistant to these antifungal agents. We report a case of breakthrough Trichosporon asahii fungemia. A 62-year-old Japanese woman with relapsed follicular lymphoma was treated empirically with broad-spectrum antibiotics and micafungin due to an intermittent fever during reinduction chemotherapy. After four cycles of anti-cancer chemotherapy, she experienced a high neutropenic fever and T. asahii was subsequently detected from a blood culture. The patient was not given voriconazole due to the contraindication for use with carbamazepine, and she was successfully treated with fluconazole plus liposomal amphotericin B without any serious complications. The combined therapy of fluconazole and liposomal amphotericin B may therefore be useful in treating T. asahii fungemia, especially in patients receiving antiepileptic agents.
ISSN:0301-486X
1573-0832
DOI:10.1007/s11046-020-00525-x