Endophthalmitis Due to Trichosporon beigelii in Acute Leukemia

We describe 2 patients with hematologic malignancy who developed endophthalmitis due to Trichosporon beigelii during the course of treatment with multiagent chemotherapy. Blood cultures revealed T beigelii for both patients. Although one of the patients was treated with fluconazole (FLCZ) and 5-fluorocytosine, the trichosporonous endophthalmitis was resistant to both drugs. This patient subsequently received amphotericin B (AMPH-B) therapy, and the eyes were treated with vitrectomy. The second patient also received AMPH-B for FLCZ-resistant trichosporonous chorioretinitis. In both patients, systemic treatment with AMPH-B successfully resolved the trichosporonous endophthalmitis that was resistant to multiple antifungal drugs. Endophthalmitis due to trichosporonosis is difficult to treat. The administration of AMPH-B is likely to be more effective in treating endophthalmitis due to trichosporonosis when the disease is at an early stage.

[1]  W. Mieler,et al.  Management of endogenous fungal endophthalmitis with voriconazole and caspofungin. , 2005, American journal of ophthalmology.

[2]  H. Kantarjian,et al.  Outcome with the hyper-CVAD regimens in lymphoblastic lymphoma. , 2004, Blood.

[3]  D. Roth,et al.  Postoperative fungal endophthalmitis caused by Trichosporon beigelii resistant to amphotericin B. , 2003, Retina.

[4]  C. A. Kauffman,et al.  Voriconazole: a new triazole antifungal agent. , 2003, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[5]  T. Walsh,et al.  Comparative Antifungal Activities and Plasma Pharmacokinetics of Micafungin (FK463) against Disseminated Candidiasis and Invasive Pulmonary Aspergillosis in Persistently Neutropenic Rabbits , 2002, Antimicrobial Agents and Chemotherapy.

[6]  T. Walsh,et al.  Uncommon opportunistic fungi: new nosocomial threats. , 2001, Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases.

[7]  T. Sugita,et al.  Isolation of Trichosporon asahii from environmental materials. , 2000, Medical mycology.

[8]  Koji Kawabata,et al.  In Vitro Activities of a New Lipopeptide Antifungal Agent, FK463, against a Variety of Clinically Important Fungi , 2000, Antimicrobial Agents and Chemotherapy.

[9]  R. Finberg,et al.  Liposomal Amphotericin B for Empirical Therapy in Patients with Persistent Fever and Neutropenia , 1999 .

[10]  A. Espinel-Ingroff.  Comparison of In Vitro Activities of the New Triazole SCH56592 and the Echinocandins MK-0991 (L-743,872) and LY303366 against Opportunistic Filamentous and Dimorphic Fungi and Yeasts , 1998, Journal of Clinical Microbiology.

[11]  P. Kamberi,et al.  Efficacy of Amphotericin B and Azoles Alone and in Combination against Disseminated Trichosporonosis in Neutropenic Mice , 1997, Chemotherapy.

[12]  T. Tani,et al.  Evaluation of plasma (1-->3)-beta-D-glucan measurement by the kinetic turbidimetric Limulus test, for the clinical diagnosis of mycotic infections. , 1997, European journal of clinical chemistry and clinical biochemistry : journal of the Forum of European Clinical Chemistry Societies.

[13]  S. Kohno,et al.  (1↠3)‐β‐D‐Glucan in culture fluid of fungi activates factor g, a limulus coagulation factor , 1995 .

[14]  G. S. Hoog,et al.  Trichosporon on humans: a practical account , 1994, Mycoses.

[15]  T. Walsh,et al.  Infections due to Trichosporon species: new concepts in mycology, pathogenesis, diagnosis and treatment. , 1993, Current topics in medical mycology.

[16]  E. Anaissie,et al.  Azole therapy for trichosporonosis: clinical evaluation of eight patients, experimental therapy for murine infection, and review. , 1992, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[17]  G. Bodey,et al.  Azole antifungal agents. , 1992, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[18]  F. Mandelli,et al.  Mitoxantrone, etoposide, and intermediate-dose cytarabine: an effective and tolerable regimen for the treatment of refractory acute myeloid leukemia. , 1991, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[19]  E. Anaissie,et al.  New spectrum of fungal infections in patients with cancer. , 1989, Reviews of infectious diseases.

[20]  T. Walsh,et al.  Trichosporonosis in Patients with Neoplastic Disease , 1986, Medicine.

[21]  G Flandrin,et al.  Proposed revised criteria for the classification of acute myeloid leukemia. A report of the French-American-British Cooperative Group. , 1985, Annals of internal medicine.

[22]  R. Levine,et al.  Metastatic fungal chorioretinitis developing during Trichosporon sepsis. , 1982, Ophthalmology.

[23]  S. Hanauer,et al.  Disseminated trichosporon beigelii (cutaneum) , 1981, Cancer.

[24]  L. Frankel,et al.  Systemic mycosis due to trichosporon cutaneum a report of two additional cases , 1980, Cancer.

[25]  R. Marier,et al.  Trichosporon cutaneum endocarditis. , 1978, Scandinavian journal of infectious diseases.

[26]  A. Cangır,et al.  Trichosporon sepsis and leukemia , 1975, Cancer.

[27]  S. Mahgoub,et al.  Postoperative endophthalmitis due to Trichosporon cutaneum. , 1974, The British journal of ophthalmology.

[28]  K. Watson,et al.  Brain abscess due to Trichosporon cutaneum. , 1970, Journal of medical microbiology.