Trichosporon beigelii causing oral mucositis and fungemia: report of one case. 1998

C F Hsu, and C C Wang, and C S Hung, and S N Cheng, and Y H Chen, and M L Chu
Department of Pediatrics, National Defense Medical Center, Taipei, Taiwan, R.O.C.

A 23-month-old boy, a victim of acute myelomonocytic leukemia (AML), was admitted for chemotherapy. On the eighth hospital day, he started a one-week course of chemotherapy with agents of epirubicin and cytosine arabinoside. Unfortunately, persistent neutropenia, deteriorating diarrhea and intermittently spiking fever developed from the sixteenth hospital day. Initially, ceftazidime and amikacin were empirically utilized. Blood culture yielded Klebsiella pneumoniae and the fever subsided for one day. Unfortunately, oral mucositis and catheter-induced phlebitis developed subsequently. Subsequently, oral nystatin and intravenous oxacillin were added. The results of cultures from both blood and oral mucosal tissue yielded a fungus. Trichosporon beigelii. We changed from an oral antifungal agent to intravenous amphotericin B on the twenty-fourth hospital day. He presented signs of septic shock with disseminated intravascular coagulopathy and expired on the twenty-fifth hospital day after failure to respond to aggressive resuscitation. We report this case to emphasize that in cytotoxic chemotherapy-induced granulocytopenic AML patients who have compromised immune systems, and who may manifest some signs or symptoms of infection, and at the same time poorly respond to interventional antibiotic treatment, the possibility of T. beigelii infection can not be neglected.

UI MeSH Term Description Entries
D007223 Infant A child between 1 and 23 months of age. Infants
D008297 Male Males
D009061 Mouth Mucosa Lining of the ORAL CAVITY, including mucosa on the GUMS; the PALATE; the LIP; the CHEEK; floor of the mouth; and other structures. The mucosa is generally a nonkeratinized stratified squamous EPITHELIUM covering muscle, bone, or glands but can show varying degree of keratinization at specific locations. Buccal Mucosa,Oral Mucosa,Mucosa, Mouth,Mucosa, Oral
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D013280 Stomatitis INFLAMMATION of the soft tissues of the MOUTH, such as MUCOSA; PALATE; GINGIVA; and LIP. Oral Mucositis,Mucositis, Oral,Oromucositis,Mucositides, Oral,Oral Mucositides,Oromucositides,Stomatitides
D014250 Trichosporon A mitosporic fungal genus causing opportunistic infections, endocarditis, fungemia, a hypersensitivity pneumonitis (see TRICHOSPORONOSIS) and white PIEDRA. Trichosporons
D016469 Fungemia The presence of fungi circulating in the blood. Opportunistic fungal sepsis is seen most often in immunosuppressed patients with severe neutropenia or in postoperative patients with intravenous catheters and usually follows prolonged antibiotic therapy.

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