リウマチ学: 現在の研究
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概要

The First Reported Case of Trichosporon asahii in Systemic Lupus Erythematosus (SLE) from Riyadh, Saudi Arabia

Albaadani A, Kallam K, Albarrag A

Background: Trichosporonosis is an emerging invasive opportunistic fungal infection in immunocompromised patients.

Case presentation: We report an unusual clinical presentation of a rare invasive fungal infection secondary to Trichosporon asahii in a 26-year-old female. This was initially a known case of Systemic Lupus Erythematosus (SLE). The patient presented with abdominal pain and distension secondary to bowel perforation. She was admitted for urgent sigmoid resection and colostomy. The surgical histopathology reported excessive infiltration of fungal elements but was inconclusive. The patient was started on ambisome; PCR then showed Trichosporon species and later the blood culture grew yeast for which caspofungin was added. However, the final identification was that of Trichosporon asahii, which is resistant to echinocandins and sensitive to amphotericin B and voriconazole. The patient stayed in the ICU for more than one month. She received broad-spectrum antibiotics and had a central venous catheter, arterial, and Quinton lines inserted for an average duration of 30 days. Ultimately, the patient died due to disseminated infection, multiple episodes of ICU acquired infections, and multi organ failure. This is the first case of Trichosporon in a SLE patient to be reported from Saudi Arabia, Riyadh at the Prince Sultan Military Medical City.

Conclusion: Trichosporon is an opportunistic fungal infection that requires a high index of clinical suspicion. Molecular diagnosis is a rapid, highly sensitive and reliable diagnostic tool that plays a crucial role in speeding up diagnosis.