Premium
Trichosporon asahii infection presenting as chronic meningo‐ventriculitis and intra ventricular fungal ball: a case report and literature review
Author(s) -
Kumar Anil,
Udayakumaran Suhas,
Babu Rachana,
Rajamma Bindhu M.,
Prakash Anupam,
Panikar Dilip,
Karim Shamsul,
Chowdhary Anuradha
Publication year - 2015
Publication title -
mycoses
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.13
H-Index - 69
eISSN - 1439-0507
pISSN - 0933-7407
DOI - 10.1111/myc.12282
Subject(s) - ventriculitis , caspofungin , voriconazole , fluconazole , flucytosine , amphotericin b , itraconazole , medicine , aspergillosis , micafungin , meningitis , posaconazole , antifungal , surgery , dermatology , immunology
Summary Central nervous system trichosporonosis is a rare clinical entity and so far only six cases including three each of brain abscess and meningitis has been on record. We report a rare case of chronic meningo‐ventriculitis and intraventricular fungal ball due to Trichosporon asahii in an 18‐year‐old immunocompetent male from Burundi, east Africa. Neuroendoscopy showed multiple nodules and a fungal ball within the ventricle, which on culture grew T. asahii . He was initially empirically treated with liposomal amphotericin B. However, the antifungal susceptibility testing of T. asahii isolate revealed high minimum inhibitory concentration for amphotericin B (2 μg ml −1 ), flucytosine (16 μg ml −1 ) and caspofungin (2 μg ml −1 ) but exhibited potent activity for voriconazole, posaconazole, itraconazole and fluconazole. The patient rapidly succumbed to cardiac arrest before antifungal therapy could be changed. Although disseminated trichosporonosis has been increasingly reported the diagnosis represents a challenge especially in rare clinical settings such as intraventricular fungal ball in the present case, which has not been described previously.