Journal of Clinical Pediatrics >
Disseminated Trichosporon asahii infection mainly manifested as digestive system infection of a child: a case report and literature review
Received date: 2025-08-22
Accepted date: 2026-01-23
Online published: 2026-03-06
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
SHEN Yiyi , QIAN Xueying , ZHENG Yucan , LU Yan , LIU Zhifeng , ZHANG Zhihua . Disseminated Trichosporon asahii infection mainly manifested as digestive system infection of a child: a case report and literature review[J]. Journal of Clinical Pediatrics, 2026 , 44(3) : 252 -257 . DOI: 10.12372/jcp.2026.25e1032
| [1] | Duarte-Oliveira C, Rodrigues F, Gon?alves SM, et al. The cell biology of the Trichosporon-Host interaction[J]. Front Cell Infect Microbiol, 2017, 7: 118. |
| [2] | 杨蓉娅, 王文岭, 敖俊红, 等. 国内阿萨希毛孢子菌首次分离及鉴定[J]. 中国医师杂志, 2002(2): 159-160. |
| Yang RY, Wang WL, Ao JH, et al. The First isolation and identification of Trichosporon Asahii in China[J]. Zhongguo Yishi Zazhi, 2002(2): 159-160. | |
| [3] | Desnos-Ollivier M, Maufrais C, Pihet M, et al. Epidemio-logical investigation for grouped cases of Trichosporon asahii using whole genome and IGS1 sequen-cing[J]. Mycoses, 2020, 63(9): 942-951. |
| [4] | de Almeida Júnior JN, Hennequin C. Invasive trichosporon infection: a systematic review on a re-emerging fungal pathogen[J]. Front Microbiol, 2016, 7: 1629. |
| [5] | Kim YJ, Kim SI, Kim YR, et al. Successful treatment of septic shock with purpura fulminans caused by Trichosporon asahii in an immunocompetent patient[J]. Ann Clin Lab Sci, 2007, 37(4): 366-369. |
| [6] | Nett JE, Andes DR. Antifungal agents: spectrum of activity, pharmacology, and clinical indications[J]. Infect Dis Clin North Am, 2016, 30(1): 51-83. |
| [7] | Sun W, Su J, Xu S et al. Trichosporon asahii causing nosocomial urinary tract infections in intensive care unit patients: genotypes, virulence factors and antifungal susceptibility testing[J]. J Med Microbiol, 2012, 61(Pt 12): 1750-1757. |
| [8] | Mahoney D, Aftandilian C. Breakthrough Trichosporon asahii in a patient with new diagnosis B-ALL on echinocandin prophylaxis: a case report[J]. J Pediatr Hematol Oncol, 2022, 44(2): e514-e517. |
| [9] | Yang F, Feng J, Wang L, et al. Disseminated Trichosporon asahii infection presenting as eosinophilia in an immunocompetent patient: A case report[J]. Indian J Med Microbiol, 2021, 39(4): 552-555. |
| [10] | Raju DS, Sugunan A, Keechilattu P, et al. Chemoport-related fungemia caused by Trichosporon asahii[J]. J Pediatr Hematol Oncol, 2019, 42(3): e193-e194. |
| [11] | Galligan ER, Fix L, Husain S, et al. Disseminated trichosporonosis with atypical histologic findings in a patient with acute lymphocytic leukemia[J]. J Cutan Pathol, 2018, 46(2): 159-161. |
| [12] | Nguyen JK, Schlichte MJ, Schady D, et al. Fatal disseminated Trichosporon asahii fungemia in a child with acute lymphoblastic leukemia and a morbilliform eruption[J]. Pediatr Dermatol, 2017, 35(1): e86-e87. |
| [13] | Kumar A, Udayakumaran S, Babu R, et al. Trichosporon asahii infection presenting as chronic meningo-ventriculitis and intra ventricular fungal ball: a case report and literature review[J]. Mycoses, 2015, 58(2): 99-103. |
| [14] | Maxfield L, Matthews JJ, Ambrosetti DR, et al. Tricho-sporon fungemia in a pediatric patient with acute lymphoblastic leukemia[J]. IDCases, 2015, 2(4): 106-108. |
| [15] | Tanyildiz HG, Yesil S, Toprak S, et al. Two case presentations infected by Trichosporon asahii and treated with voriconazole successfully[J]. Case Rep Infect Dis, 2015, 2015: 651315. |
| [16] | Negi V, Sharma M, Juyal D, et al. Disseminated trichosporonosis due to Trichosporon asahii in a diabetic patient[J]. Indian J Pathol Microbiol, 2015, 58(2): 246-248. |
| [17] | Karapinar DY, Karada? N, Yazici P, et al. Trichosporon asahii, sepsis, and secondary hemophagocytic lymphohistiocytosis in children with hematologic malignancy[J]. Pediatr Hematol Oncol, 2014, 31(3): 282-284. |
| [18] | Ozkaya-Parlakay A, Karadag-Oncel E, Cengiz AB, et al. Trichosporon asahii sepsis in a patient with pediatric malignancy[J]. J Microbiol Immunol Infect, 2013, 49(1): 146-149. |
| [19] | 郑晓丽, 王志东, 闫洪敏, 等. 异基因造血干细胞移植过程中并发播散性阿萨希毛孢子菌感染1例并文献复习[J]. 临床血液学杂志, 2013, 26(5): 312-314. |
| Zheng XL, Wang ZD, Yan HM, et al. Disseminated trichosporon asahii infection in an aplastic anemia patient underwen t unrelated hematopoietic stem cell transplantation: a case report and literature review[J]. Linchuang Xueyexue Zazhi, 2013, 26(5):312-314. | |
| [20] | Kudo K, Terui K, Sasaki S, et al. Voriconazole for both successful treatment of disseminated Trichosporon asahii infection and subsequent cord blood transplantation in an infant with acute myelogenous leukemia[J]. Bone Marrow Transplant, 2011, 46(2): 310. |
| [21] | Hosoki K, Iwamoto S, Kumamoto T, et al. Early detection of breakthrough trichosporonosis by serum PCR in a cord blood transplant recipient being prophylactically treated with voriconazole[J]. J Pediatr Hematol Oncol, 2008, 30(12): 917-919. |
| [22] | Tsuji Y, Tokimatsu I, Sugita T, et al. Quantitative PCR assay used to monitor serum Trichosporon asahii DNA concentrations in disseminated trichosporonosis[J]. Pediatr Infect Dis J, 2008, 27(11): 1035-1037. |
| [23] | Thibeault R, Champagne M, de Repentigny L, et al. Fatal disseminated Trichosporon asahii infection in a child with acute lymphoblastic leukemia[J]. Can J Infect Dis Med Microbiol, 2008, 19(2): 203-205. |
| [24] | Ghiasian SA, Maghsood AH, Mirhendi SH. Disseminated, fatal Trichosporon asahii infection in a bone marrow transplant recipient[J]. J Microbiol Immunol Infect, 2006, 39(5): 426-429. |
| [25] | Antachopoulos C, Papakonstantinou E, Dotis J, et al. Fungemia due to Trichosporon asahii in a neutropenic child refractory to amphotericin B: clearance with voriconazole[J]. J Pediatr Hematol Oncol, 2005, 27(5): 283-285. |
| [26] | Meyer MH, Letscher-Bru V, Waller J, et al. Chronic disseminated Trichosporon asahii infection in a leukemic child[J]. Clin Infect Dis, 2002, 35(2): e22-e25. |
| [27] | Itoh T, Hosokawa H, Kohdera U, et al. Disseminated infection with Trichosporon asahii[J]. Mycoses, 1996, 39(5-6): 195-199. |
| [28] | Khan MID, Sahni BAK, Basu CA, et al. Trichosporon asahii urinary tract infection in immunocompetent patients[J]. Medical Journal Armed Forces India, 2015, 71(4): 373-376. |
| [29] | Al Momani M, Yusef DH, Hamasha D, et al. Complicated Trichosporon asahii mastoiditis in immunocompetent child[J]. BMC Infectious Diseases, 2021, 21(1): 1-4. |
| [30] | Almeida JND, Moreno L, Francisco EC, et al. Trichosporon asahii superinfections in critically ill COVID patients overexposed to antimicrobials and corticosteroids[J]. Mycoses, 2021: 64(8): 817-822. |
| [31] | Mina S, Yaakoub H, Annweiler C, et al. COVID-19 and fungal infections: a double debacle[J]. Microbes Infect, 2022, 24(8): 105039. |
| [32] | Chang D, Harfouch CW, Melendez ML. Trichosporon asahii opportunistic pneumonia after a severe COVID-19 infection[J]. IDCases, 2023, 31: e1701. |
| [33] | Diane Rivet-Danon, Juliette Guitard, Frederic Grenouillet, et al. Rapid diagnosis of cryptococcosis using an antigen detection immunochromatographic test. J Infect, 2015, 70(5): 499-503. |
| [34] | Liao Y, Lu X, Yang S, et al. Epidemiology and outcome of Trichosporon Fungemia: a review of 185 reported cases from 1975 to 2014[J]. Open Forum Infect Dis, 2015, 2(4): ofv141. |
| [35] | Miceli MH, Diaz JA, Lee SA. Emerging opportunistic yeast infections[J]. Lancet Infect Dis, 2011, 11(2): 142-151. |
| [36] | Francisco EC, de Almeida Junior JN, Queiroz-Telles F, et al. Correlation of Trichosporon asahii genotypes with anatomical sites and antifungal susceptibility profiles: data analyses from 284 isolates collected in the last 22 years across 24 medical centers[J]. Antimicrob Agents Chemother, 2021, 65(3): e01104-20. |
| [37] | 张德全, 夏志宽, 敖俊红, 等. 阿萨希毛孢子菌感染治疗新进展[J]. 中国皮肤性病学杂志, 2015, 29(8): 861-863. |
| Zhang DQ, Xia ZK, Ao JH, et al. Recent progress in anti-infective therapy of Trichosporon Asahii[J]. Zhongguo Pifu Xingbingxue Zazhi, 2015, 29(8): 861-863. | |
| [38] | DE Almeida JJ, Hennequin C. Invasive trichosporon infection: a systematic review on a re-emerging fungal pathogen[J]. Front Microbiol, 2016, 7: 1629. |
| [39] | Yang RY, Wang WL, Ao JH, et al. Pathogenicity of Trichosporon asahii in a murine model of disseminated trichosporonosis[J]. Chin Med J (Engl), 2008, 121(24): 2557-2560. |
| [40] | Li H, Qiao J, Wan Z, et al. In vitro interaction of itraconazole with amphotericin B, caspofungin, and terbinafine against clinical isolates of Trichosporon asahii[J]. Mycopathologia, 2011, 171(5): 345-348. |
/
| 〈 |
|
〉 |
