Hematogenous trichosporonosis in cancer patients: report of 12 cases including 5 during prophylaxis with itraconazol.

摘要: Twelve cases of Trichosporon spp. fungemias occurring in a national cancer institution within 10 years are described. The trend hematogenous trichosporonosis the last is increasing. While no occurred 1988–1991, after 1991, was most common species among non-Candida 1993–1997. 12 fungemia included 5 that started while patients were receiving prophylaxis with oral itraconazole, and 2 appeared despite empiric therapy amphotericin B. Five catheter associated. Risk factors for were: central venous catheter, broad-spectrum antibiotics (third-generation cephalosporins plus aminoglycoside); all but 1 had neutropenia antineoplastic chemotherapy. All died systemic fungal infection (83.3% mortality). Amphotericin B administered to patient, who not treated because he day his culture found be positive T. beigelii, before antifungals administered. infected pullulans related, these died. One remaining 9 caused by capitatum (Blastoschizomyces capitatus), 8 beigelii. Only cured, combination fluconazole, monotherapy. Several risk (neutropenia, acute leukemia, prior or as source fungemia, breakthrough fungemia) significantly associated comparison 63 C. albicans candidemia same period at institution. Attributable mortality also higher vs 15.8%, P<0.001) than candidiasis.