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

• Published in: Mycopathologia (1975) Vol. 186; no. 1; pp. 113 - 117
• Main Authors: Itoh, Kazuhiro, Iwasaki, Hiromichi, Negoro, Eiju, Shigemi, Hiroko, Tokimatsu, Issei, Tsutani, Hiroshi, Yamauchi, Takahiro
• Format: Journal Article
• Language: English
• Published: Dordrecht Springer Netherlands 01-03-2021; Springer; Springer Nature B.V
• 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; Trichosporonosis; Liposomal amphotericin B; Fluconazole; Immunocompromised host; Hematologic neoplasms
• ISSN: 0301-486X; 1573-0832
• DOI: 10.1007/s11046-020-00525-x

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.