Experimental Trichosporon Infection in Persistently Granulocytopenic Rabbits: Implications for Pathogenesis, Diagnosis, and Treatment of an Emerging Opportunistic Mycosis

• Published in: The Journal of infectious diseases Vol. 166; no. 1; pp. 121 - 133
• Main Authors: Walsh, Thomas J., Lee, James W., Melcher, Gregory P., Navarro, Eileen, Bacher, John, Callender, Diana, Reed, Kurt D., Wu, Teresa, Lopez-Berestein, Gabriel, Pizzo, Philip A.
• Format: Journal Article
• Language: English
• Published: Chicago, IL The University of Chicago Press 01-07-1992; University of Chicago Press
• Subjects: Agranulocytosis - complications; Animals; Antifungal Agents - therapeutic use; Antifungals; Antigens; Antigens, Fungal - blood; Biological and medical sciences; Cell walls; Chorioretinitis - diagnosis; Chorioretinitis - drug therapy; Chorioretinitis - etiology; Choroid - microbiology; Dermatomycoses - diagnosis; Dermatomycoses - drug therapy; Dermatomycoses - etiology; Digestive System - microbiology; Disease Models, Animal; Female; Gastrointestinal Diseases - diagnosis; Gastrointestinal Diseases - drug therapy; Gastrointestinal Diseases - etiology; Gastrointestinal tract; Immunocompromised Host; Immunosuppression; Infections; Infectious diseases; Inoculation; Inoculum; Kidney - microbiology; Kidney Diseases - diagnosis; Kidney Diseases - drug therapy; Kidney Diseases - etiology; Lesions; Lung - microbiology; Lung Diseases, Fungal - diagnosis; Lung Diseases, Fungal - drug therapy; Lung Diseases, Fungal - etiology; Major Articles; Medical sciences; Microscopy, Immunoelectron; Mycoses - diagnosis; Mycoses - etiology; Mycoses - therapy; Opportunistic Infections - diagnosis; Opportunistic Infections - drug therapy; Opportunistic Infections - etiology; Polysaccharides; Rabbits; Skin - microbiology; Specific Pathogen-Free Organisms; Trichosporon; Trichosporon - immunology; Trichosporon - ultrastructure; Trichosporon beigelii; Immunohistochemistry; Skin disease; Urinary system disease; Mycosis; Pathophysiology; Respiratory disease; Antibody; Etiopathogenesis; Medical screening; Result; Infection; Antigen; Pathology; Eye disease; Chemotherapy; Microbiological investigation; Treatment; Immunological investigation; Ultrastructure; Diagnosis; Technique
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1093/infdis/166.1.121

Disseminated Trichosporon infection, an uncommon but emerging opportunistic mycosis due to Trichosporon beigelii, is frequently difficult to diagnose, refractory to treatment, and associated with a high attributable mortality. Models of disseminated and gastrointestinal Trichosporon infection were developed in persistently granulocytopenic rabbits. The patterns of infection resembled those of clinical disease, including cutaneous lesions, chorioretinitis, renal infection, pulmonary infection, and antigenemia cross-reactive with cryptococcal capsular polysaccharide. Antigenemia, an early manifestation of disseminated Trichosporon infection, originated in vivo from a fibrillar extracellular matrix. Trichosporon organisms disseminated from the gastrointestinal tract to visceral tissue in colonized immunosuppressed rabbits, whereas there was no dissemination from the gastrointestinal tract of otherwise normal rabbits. The antifungal triazoles, fluconazole and SCH 39304, were most active; maximum tolerated doses of amphotericin Band liposomal amphotericin B were ineffective. Trichosporon antigenemia declined in response to antifungal therapy. These findings contribute to improved understanding of the pathogenesis, diagnosis, and treatment of disseminated Trichosporon infection.