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Pathology of Trichosporonosis

Dr Sampurna Roy MD


   

The Trichosporon species have recently emerged as significant systemic pathogens in immunocompromised patients.

These yeast-like fungi are soil saprophytes that also form a minor component of normal skin flora.

T. beigelii ( Syn: T. cutaneum ), is a frequent pathogen and is better known as the agent of white piedra, a nodule-forming trichomycosis. 

(i) Trichosporon cutaneum and Trichosporon asteroides (Superficial cutaneous infections)

(ii) Trichosporon ovoides [ White piedra (scalp) ] ; Trichosporon inkin [White piedra (pubic)].

(iii) Trichosporon asahii (common) & Trichosporon mucoides (Systemic trichosporonosis)

Disseminated trichosporonosis occurs principally in patients who are neutropenic as a result of treatment for acute leukemia, lymphoma, or solid tumours but it has also been reported in immunosuppressed transplant recipients.

Purpuric cutaneous nodules are a frequent clinical manifestation, and the lungs, kidneys, myocardium, liver, spleen, and bone marrow are also frequently involved.

Systemic lesions consist of abscesses, granulomas, or nodular infarcts, the last a consequence of mycotic vascular invasion and occlusion.

In tissue sections, the Trichosporon spp can be recognized as pleomorphic blastoconidia , 3 to 8 micrometer in diameter, septate hyphae, and arthroconidia that are produced by fragmentation of hyphal segments.

These fungi may be difficult to distinguish from some other opportunistic pathogen, such as the Candida species, if arthroconidia are inconspicuous.

A presumptive histologic diagnosis of trichosporonosis is therefore best confirmed by culture or immunoflourescence.

                      

Further reading

[An overview on Trichosporon asahii and its infections].

Differentiation of the emerging human pathogens Trichosporon asahii and Trichosporon asteroides from other pathogenic yeasts and moulds by using species-specific monoclonal antibodies.

Opportunistic yeast infections: candidiasis, cryptococcosis, trichosporonosis and geotrichosis.

Invasive trichosporonosis in an AIDS patient: case report and review of the literature.

Histopathological evaluation of the efficacy of antifungals for experimental Trichosporon bloodstream infection.

Development of a peptide nucleic acid probe to Trichosporon species and identification of trichosporonosis by use of in situ hybridization in formalin-fixed and paraffin-embedded (FFPE) sections.

Trichosporon inkin, an unusual agent of fungal sinusitis: a report from south India.

Disseminated trichosporonosis in a burn patient: meningitis and cerebral abscess due to Trichosporon asahii.

Primary cutaneous trichosporonosis caused by Trichosporon dermatis in an immunocompetent man.

Experimental pathogenicity of a clinical isolate of Trichosporon dermatis in a murine model.

Differential diagnosis of trichosporonosis using conventional histopathological stains and electron microscopy.

Emerging deep-seated fungal infection, trichosporonosis. 

Autopsy case of disseminated Trichosporon inkin infection identified with molecular biological and biochemical methods.

March 2016

Dr Sampurna Roy  MD

Consultant  Histopathologist (Kolkata - India)

 

 

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