Trichosporon asahii (formerly T. beigelii) is a rare cause of human
infections with very varied clinical manifestations ranging from superficial
infections to severe and systemic diseases. T. asahii is a life-threatening opportunistic pathogen especially for granulocytopenic, immunocompromised and immunodeficient patients. It is the possible cause of
summer-type hypersensitivity pneumonitis in Japan and systemic
infections in transplant patients, patients on
corticosteroid therapy, patients with solid
tumors and
burn patients. Cases of
infection in non-immunocompromised surgical patients and patients with long-term stay in ICU are described in the literature. We report on T. asahii
fungemia in a polytraumatized neurosurgical patient with long-term stay in the hospital. Urinary tract was the source of
fungemia, with the same pathogen isolated from urine and blood at the same time. In the Referral Center for Systemic
Mycoses, Croatian Institute of Public Health, Zagreb, the strain from the urine and blood culture was identified as T. asahii, with good susceptibility to
fluconazole,
voriconazole and 5 fluorocytosine, reduced susceptibility to
itraconazole and resistance to
amphotericin B. The patient responded to
fluconazole therapy very well. Since systemic
trichosporonoses are generally associated with immunocompromised patients (hematologic, granulocytopenic and
AIDS patients), this case confirms the possibility of
infection with this pathogen in patients with long-term
hospital stay and reduced local immunity, but without classic immunodeficiency.