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Successful Treatment of Breakthrough Trichosporon asahii Fungemia by the Combination Therapy of Fluconazole and Liposomal Amphotericin B in a Patient with Follicular Lymphoma

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Abstract

Invasive trichosporonosis is a rare and lethal fungal infection that occurs in immunocompromised patients. Breakthrough trichosporonosis can occur in patients treated with echinocandins since Trichosporon spp. are resistant to these antifungal agents. We report a case of breakthrough Trichosporon asahii fungemia. A 62-year-old Japanese woman with relapsed follicular lymphoma was treated empirically with broad-spectrum antibiotics and micafungin due to an intermittent fever during reinduction chemotherapy. After four cycles of anti-cancer chemotherapy, she experienced a high neutropenic fever and T. asahii was subsequently detected from a blood culture. The patient was not given voriconazole due to the contraindication for use with carbamazepine, and she was successfully treated with fluconazole plus liposomal amphotericin B without any serious complications. The combined therapy of fluconazole and liposomal amphotericin B may therefore be useful in treating T. asahii fungemia, especially in patients receiving antiepileptic agents.

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Data Availability

The data and materials generated and/or analyzed during the present study are available from the corresponding author upon reasonable request.

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Authors and Affiliations

  1. Department of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuoka-shimoaizuki, Eiheiji-cho, Fukui, Yoshida-gun, 910-1193, Japan

    Kazuhiro Itoh, Eiju Negoro & Takahiro Yamauchi

  2. Department of Infection Control and Prevention, University of Fukui Hospital, Fukui, Japan

    Kazuhiro Itoh & Hiromichi Iwasaki

  3. Department of Internal Medicine, National Hospital Organization Awara Hospital, Fukui, Japan

    Kazuhiro Itoh & Hiroshi Tsutani

  4. Department of Infection Control and Laboratory Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan

    Hiroko Shigemi

  5. Department of Medicine, Division of Clinical Infectious Diseases, School of Medicine, Showa University, Tokyo, Japan

    Issei Tokimatsu

Authors
  1. Kazuhiro Itoh
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  2. Hiromichi Iwasaki
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  3. Eiju Negoro
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  4. Hiroko Shigemi
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  7. Takahiro Yamauchi
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Correspondence to Kazuhiro Itoh.

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The authors declare that they have neither conflict of interest.

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The authors agreed to have this article published in Mycopathologia.

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All procedures used in this work were approved by the Ethics Committee of the University of Fukui.

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Informed consent for the publication of this case was obtained from the patient’s husband, because the patient had cognitive impairment.

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Handling Editor: Vishnu Chaturvedi.

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Itoh, K., Iwasaki, H., Negoro, E. et al. Successful Treatment of Breakthrough Trichosporon asahii Fungemia by the Combination Therapy of Fluconazole and Liposomal Amphotericin B in a Patient with Follicular Lymphoma. Mycopathologia 186, 113–117 (2021). https://doi.org/10.1007/s11046-020-00525-x

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  • DOI: https://doi.org/10.1007/s11046-020-00525-x

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