RESUMO
During an epidemiological survey, a potential novel species within the basidiomycetous yeast genus Trichosporon was observed. The clinical strain was obtained from a urine sample taken from a Brazilian kidney transplant recipient. The strain was molecularly identified using the intergenic spacer (IGS1) ribosomal DNA locus and a subsequent phylogenetic analysis showed that multiple strains that were previously reported by other studies shared an identical IGS1-genotype most closely related to that of Trichosporon inkin. However, none of these studies provided an in-depth characterization of the involved strains to describe it as a new taxon. Here, we present the novel clinically relevant yeast for which we propose the name Trichosporon austroamericanum sp. nov. (holotype CBS H-24937). T. austroamericanum can be distinguished from other siblings in the genus Trichosporon using morphological, physiological, and phylogenetic characters.
Assuntos
DNA Fúngico , DNA Espaçador Ribossômico , Filogenia , Análise de Sequência de DNA , Transplantados , Trichosporon , Tricosporonose , Trichosporon/classificação , Trichosporon/genética , Trichosporon/isolamento & purificação , DNA Espaçador Ribossômico/genética , DNA Espaçador Ribossômico/química , DNA Fúngico/genética , Humanos , Brasil , Tricosporonose/microbiologia , Análise por Conglomerados , Técnicas de Tipagem Micológica , Transplante de Rim , Microscopia , GenótipoRESUMO
Trichosporon species are emerging as opportunistic pathogens that mainly affect immunocompromised patients. Patients with onco-hematological diseases usually present with fungemia by Trichosporon species, especially by T. asahii. Reports of this infection by other species of the genus are uncommon. Thus, in this paper, we present a case of T. inkin fungemia in a 39-year-old female patient with intestinal obstruction and absence of malignant hematological diseases. The late mycological diagnosis, the ineffective control of her pre-existing conditions and consequent failure to start antifungal therapy were the contributing factors for the patient's death.
Lay abstract Trichosporon species have been emerged as opportunistic fungi that mainly affect patients with low immunity. Hematological (blood related) cancer patients usually present with bloodstream infection with Trichosporon species, particularly Trichosporon asahii. Reports of this infection by other species of the genus are uncommon. Thus, in this paper, we present a case of bloodstream infection by Trichosporon inkin in a 39-year-old female patient with intestinal obstruction and absence of hematological cancer. The late fungal diagnosis, the ineffective control of the first symptoms and consequent failure to start specific medication were the factors that led to the patient's death.
Assuntos
Basidiomycota , Fungemia , Trichosporon , Adulto , Antifúngicos/uso terapêutico , Feminino , Fungemia/diagnóstico , Fungemia/tratamento farmacológico , HumanosRESUMO
BACKGROUND: Trichosporon species may colonize the skin, respiratory tract and gastrointestinal tract of human beings. The yeast is recognized as etiological agent of white piedra, a superficial mycosis. Nevertheless, immunocompromised hosts may develop invasive Trichosporonosis. Central nervous system trichosporonosis is a very rare clinical manifestation. In fact, only a few cases have been published in the literature and none of them was caused by Trichosporon inkin. CASE PRESENTATION: Here we report the first clinical case of meningoencephalitis due to this species in a female previously healthy patient under corticosteroids and antibiotics therapy for several months. She was submitted to an invasive procedure to remove a left sided acoustic neuroma and further developed a cerebrospinal fistula. After some days of the procedure, she presented a predominantly and intensive occipital holocranial headache, followed by vomiting, hyporexia, weight loss, asthenia, irritability, difficulty to concentrate and rotator vertigo. The patient further developed a cerebrospinal fistula in the occipital region and was submitted to a surgical correction. After several months of clinical interventions, she was diagnosed with CNS Trichosporonosis, after Magnetic Resonance Imaging and positive microbiological cultures obtained within two different occasions (2 weeks apart). Despite the antifungal therapy with Amphotericin B and Voriconazole, the patient did not survive. CONCLUSIONS: Despite CNS Fungal infections are mostly due to Cryptococcus spp., other emergent yeasts, such as T. inkin may be considered as a likely etiological agent. This is the first case report of CNS Trichosporonosis, where species identification was performed with rDNA sequencing.