Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Jul 9:12:2015-2018.
doi: 10.2147/IDR.S211148. eCollection 2019.

Successful treatment of Trichosporon asahii fungemia with isavuconazole in a patient with hematologic malignancies

Guillaume Feugray  1 , Daphné Krzisch  2 , Marion Dehais  1 , Romy Razakandrainibe  3 , Gilles Gargala  1   3 , Loic Favennec  1   3 , Stéphane Lepretre  2 , Vincent Camus  2 , Damien Costa  1   3
Affiliations

Successful treatment of Trichosporon asahii fungemia with isavuconazole in a patient with hematologic malignancies

Guillaume Feugray et al. Infect Drug Resist. .

Abstract

Trichosporon spp. are yeast-like microorganisms responsible for skin, urinary, pulmonary, or bloodstream infections. Due to intrinsic resistance to echinocandins, poor susceptibility to polyenes, and preferred occurrence in immunocompromised patients, such infections are often of poor prognosis. Yet no consensual therapeutic guidelines are presently available. Several clinical cases of Trichosporon infections have been successfully treated with azole therapy, including voriconazole which appeared frequently effective against Trichosporon both in vitro and in vivo. However, the low efficacy associated with some Trichosporon genotypes, complex pharmacokinetics, and the side effects of voriconazole represent limitations for its use and has prompted a search for other therapeutic options. Here, we report a case of T. asahii fungemia in a patient with B-cell acute lymphoblastic leukemia which was successfully treated with isavuconazole consecutive to stopping voriconazole therapy due to severe side effects. This observation suggests that isavuconazole with a similar spectrum to voriconazole, fewer pharmacology interactions, and side effects may be considered as a valuable therapeutic option against Trichosporon infections.

Keywords: Trichosporon asahii; acute lymphoid leukemia; fungemia; isavuconazole.

PubMed Disclaimer

Conflict of interest statement

Dr Vincent Camus report personal fees, non-financial support from ROCHE, personal fees, non-financial support from AMGEN, outside the submitted work. The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
Case study timeline.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Karigane D, Sakurai M, Matsuyama E, et al. Successful treatment of breakthrough disseminated Trichosporon asahii fungemia in a patient with acute myeloid leukemia receiving itraconazole prophylaxis. Med Mycol Case Rep. 2018;20:1–3. doi:10.1016/j.mmcr.2017.11.006 - DOI - PMC - PubMed
    1. Asada N, Uryu H, Koseki M, Takeuchi M, Komatsu M, Matsue K. Successful treatment of breakthrough Trichosporon asahii fungemia with voriconazole in a patient with acute myeloid leukemia. Clin Infect Dis. 2006;43(4):e39–e41. doi:10.1086/505970 - DOI - PubMed
    1. Arendrup MC, Boekhout T, Akova M, Meis JF, Cornely OA, Lortholary O. ESCMID† and ECMM‡ joint clinical guidelines for the diagnosis and management of rare invasive yeast infections. Clin Microbiol Infect. 2014;20:76–98. doi:10.1111/1469-0691.12360 - DOI - PubMed
    1. Shang S-T, Yang Y-S, Peng M-Y. Nosocomial Trichosporon asahii fungemia in a patient with secondary hemochromatosis: a rare case report. J Microbiol Immunol Infect. 2010;43(1):77–80. doi:10.1016/S1684-1182(10)60012-6 - DOI - PubMed
    1. Thompson GR, Wiederhold NP, Sutton DA, Fothergill A, Patterson TF. In vitro activity of isavuconazole against Trichosporon, Rhodotorula, Geotrichum, Saccharomyces and Pichia species. J Antimicrob Chemother. 2009;64(1):79–83. doi:10.1093/jac/dkp138 - DOI - PubMed