Trichosporonosis

Trichosporonosis
Other names: Trichosporon infection[1]
Top: Disseminated trichosporonosis Bottom:Trichosporon asahii
Specialty	Infectious disease
Symptoms	Fever, skin lesion[2]
Types	Invasive, superficial[3]
Causes	Trichosporon asahii(most cases)[4]
Risk factors	Immunosuppression, Cystic fibrosis, HIV/AIDS[3]
Diagnostic method	Microscopic exam of affected tissue[3]
Differential diagnosis	Invasive candidiasis, aspergillosis, cryptococcosis[3]
Medication	Antifungals (voriconazole, amphotericin B, fluconazole)[3]

Trichosporonosis is a systemic disease associated with fungi in the genus Trichosporon.It can occur in people who are immunosuppressed.^[5]Trichosporon asahii is the predominant cause of Trichosporonosis, especially invasive forms of the infection. While other Trichosporon species can cause infections, T. asahii accounts for the majority of clinical cases and is considered the most pathogenic and lethal species within the genus^[4]

Trichosporon species are found worldwide, especially in tropical and temperate regions like South America, Southeast Asia, and parts of the U.S.^[6]

Signs and symptoms

In terms of the presentation we find that superficial trichosporonosis, is usually mild and asymptomatic. However invasive trichosporonosis is more serious and occurs in people with weakened immune systems, where symptoms can include:^[3][2]

• Persistent fever
• Fungemia
• Respiratory symptoms
• Skin lesions

Cause

Trichosporon is a genus of anamorphic fungi in the family Trichosporonaceae. All species of Trichosporon are yeasts with no known teleomorphs. Most are typically isolated from soil, but several species occur as a natural part of the skin microbiota of humans and other animals.Trichosporon asahii is a non-Candida yeast that has been reported to cause infections in immunocompromised patients. T. asahii is the most prominent human pathogen in its genus, causing more than half of all Trichosporon infections^[4][7][8]

Risk factors

The risk factors for infection include:^[3]

• Immunosuppression
• Chemotherapy
• Neutropenia
• Cystic fibrosis
• Malignancy

Mechanism

Invasive infections often begin with a breach in the mucosal or cutaneous surfaces. This can be due to factors like chemotherapy-induced epithelial damage, severe burns, or the use of intravascular catheters.Trichosporonosis is an opportunistic fungal infection, primarily affecting individuals with weakened immune systems. It starts when Trichosporon fungi, enter the bloodstream, often through damaged skin or medical devices. The fungi then cause disease by forming protective biofilms and producing enzymes(proteases,lipases,esterases) that damage host tissues, leading to potentially severe infections^[8][9]

Diagnosis

As to the diagnosis of Trichosporonosis we find that it often involves:^[3]

• Microscopic exam
• Fungal cultures
• PCR-based technique

Differential diagnosis

Conditions that may present similar include:^[3]

• Invasive candidiasis
• Aspergillosis
• Cryptococcosis

Treatment

In terms of treatment we find that it depends on severity and location of infection, among first-line antifungal therapy there is: voriconazol, posaconazole, and fluconazole^[10]

Amphotericin B is another option and should be used for resistant and unresponsive trichosporonosis, combined with voriconazole or micafungin. Echinocandins are ineffective against this fungal infection^[3]

Epidemiology

Trichosporonosis between 1997 and 2005 was found it in tropical and temperate areas like:^[3]

• South America
• Middle East
• India
• Africa
• Europe
• Japan

History

As to history we find that the discovery of Trichosporonosis is attributed to Hermann Beigel, who first described the genus Trichosporon in 1865. He identified it as the agent responsible for benign hair infection known as white piedra^[4]

References

External links