Abstract

Case Report

A rare case of recurrent urinary tract infection due to Trichosporon species in an immune-competent diabetic female patient

Bhuvan Saud*, Saroj Adhikari, Govinda Paudel and Sunita Wagle

Published: 24 September, 2019 | Volume 3 - Issue 1 | Pages: 026-028

Trichosporonosis is a disease caused by Trichosporon spp. which are ubiquitous anamorphic yeast that commonly inhabit the soil. In human they are found in the skin, gastrointestinal tract and respiratory tract. Globally, Trichosporon spp. infection is rare and remains scantily reported in urinary tract infections and disseminated invasive infection amongst immunocompromised and cancer patients with neutropenia. Trichosporon asahii is the most commonly reported species. Virulence factors like proteinases, lipases, and phospholipases may be responsible for disease manifestation. We report a case of recurrent urinary tract infection due to Trichosporon spp. in a 62-year-old immunocompetent diabetic female which remained misdiagnosed for a long period of time. The patient was subsequently treated successfully by oral fluconazole drug.

Read Full Article HTML DOI: 10.29328/journal.acr.1001017 Cite this Article Read Full Article PDF

Keywords:

Trichosporonosis; Diabetic; Urinary Tract infection; Nepal

References

  1. Colombo AL, Padovan AC, Chaves GM. Current knowledge of Trichosporon spp. and Trichosporonosis. Clinical microbiology reviews. 2011; 24: 682-700. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/21976604
  2. Pagano L, Caira M, Candoni A, Offidani M, Fianchi L, et al. The epidemiology of fungal infections in patients with hematologic malignancies: the SEIFEM-2004 study. Haematologica. 2006; 91: 1068-1075. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/16885047
  3. Wolf DG, Falk R, Hacham M, Theelen B, Boekhout T, et al. Multidrug-resistant Trichosporon asahii infection of nongranulocytopenic patients in three intensive care units. J Clin Microbiol. 2001; 39: 4420-4425. PubMed: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC88559/
  4. Kumar S, Bandyopadhyay M, Mondal S, Pal N. A rare case of nosocomial urinary tract infection due to Trichosporon asahii. J Glob Infect Dis. 2011; 3: 319-310. PubMed: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3162825/
  5. Sah R, Soin AS, Chawla S, Wadhwa T, Gupta N. Disseminated Trichosporon asahii infection in a combined liver‐kidney transplant recipient successfully treated with voriconazole. Immun Inflamm Dis. 2019; 7: 125–129. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/31006179
  6. Cardenas-de la Garza JA, Ancer-Arellano J, Cuellar-Barboza A, et al. Disseminated Trichosporon asahii infection in a patient with acute myeloid leukemia. J Dermatol. 2019; 46: e128-129. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/30295013
  7. Iken M, Belkouch A, Bellarj B, Naoui H, Boumhil L, et al. A rare case of urinary tract infection due to Trichosporonasahii in a diabetic patient. Pan Afr Med J. 2015; 20: 127. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/26097631
  8. Roman AD, Salvaña EM, Guzman-Peñamora MA, Roxas EA, Leyritana KT, et al. Invasive Trichosporonosis in an AIDS patient: case report and review of the literature. Int J STD AIDS. 2014; 25: 70-75. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/23970618
  9. Khan ID, Sahni AK, Basu A, Haleem S. Trichosporon asahii urinary tract infection in immunocompetent patients. Med J Armed Forces India. 2015; 71: 373-376. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/26663967
  10. Ebright JR, Fairfax MR, Vazquez JA. Trichosporon asahii, a non-Candida yeast that caused fatal septic shock in a patient without cancer or neutropenia. Clin Infect Dis. 2001; 33: e28-30. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/11477533
  11. Ahmad S, Al-Mahmeed M, Khan ZU. Characterization of Trichosporon species isolated from clinical specimens in Kuwait. J Med Microbiol. 2005; 54: 639-646. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/15947428
  12. Silvestre Junior AM, Miranda MA, Camargo ZP. Trichosporon species isolated from the perigenital region, urine and catheters of a Brazilian population. Braz J Microbiol. 2010; 41: 628-634. PubMed: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3768649/
  13. Treviño M, García-Riestra C, Areses P, García X, Navarro D, et al. Emerging Trichosporon asahii in elderly patients: epidemiological and molecular analysis by the DiversiLab system. Eur J Clin Microbiol Infect Dis. 2014; 33: 1497-503. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/24718613
  14. Mattede MD, Piras C, Mattede KD, Ferrari AT, Baldotto LS, et al. Urinary tract infections due to Trichosporon spp. in severely ill patients in an intensive care unit. Rev Bras Ter Intensiva. 2015; 27: 247-251. PubMed: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4592119/
  15. Thibeault R, Champagne M, de Repentigny L, Fournet JC, Tapiero B, et al. Fatal disseminated Trichosporon asahii infection in a child with acute lymphoblastic leukemia. Can J Infect Dis Med Microbiol. 2008; 19: 203-205. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/19352453
  16. Tsai MJ, Chang WA, Tsai KB, Chen HC, Hwang JJ, et al. Probable invasive pulmonary Trichosporonosis in a diabetic patient. Am J Respir Crit Care Med. 2011; 184: 982-982. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/22003150
  17. Kucukates E, Balkan I, Hondur N. A rare case of urinary tract infection due to Trichosporonasahii. J Pak Med Assoc. 2013; 63: 1041-1043.
  18. Negi V, Sharma M, Juyal D, Kotian S, Sharma N. Disseminated Trichosporonosis due to Trichosporon asahii in a diabetic patient. Indian J Pathol Microbiol. 2015; 58: 246-248. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/25885147
  19. Premamalini T, Anitha S, Rajyoganandh SV, Veena H, Kindo AJ. Complicated urinary tract infection by Trichosporon loubieri. Med Mycol Case Rep. 2019; 24: 86-89. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/31080715

Figures:

Figure 1

Figure 1

Figure 1

Figure 2

Similar Articles

Recently Viewed

Read More

Most Viewed

Read More

Help ?