Abstract:

As a conditional pathogenic fungus, invasive or disseminated Trichosporon asahii infection mostly occurs in immunodeficient patients, and cases involving the digestive system are relatively rare. This paper reports a rare case of disseminated Trichosporon asahii infection in a child without underlying diseases, mainly involving the gastrointestinal tract, liver and gallbladder, and abdominal lymph nodes. In October 2023, a 7-year-and-6-month-old male child was admitted to our hospital with "abdominal pain for 5 months, anemia accompanied by intermittent fever for more than 3 months". The main clinical manifestations were abdominal pain, anemia, and recurrent fever. Imaging, endoscopic, and pathological examinations indicated that the infection involved the liver and gallbladder, stomach, duodenum, and mesenteric lymph nodes. Multiple antifungal therapies were ineffective. Ultimately, Trichosporon asahii infection was confirmed by next-generation sequencing (NGS) of tissue pathogens. The patient's condition improved after receiving treatment with posaconazole and flucytosine. Patients without underlying diseases rarely develop disseminated Trichosporon asahii infections. In addition to fever, patients with digestive system infections may present with abdominal pain and jaundice. Those with gastrointestinal involvement may develop complications such as anemia and weight loss. Early diagnosis of this disease is difficult, and the mortality rate is high. Voriconazole is the first-choice treatment, and combination antifungal therapy can improve its efficacy.

Key words: Trichosporon asahii, disseminated infection, child