Successful Treatment of Trichosporon asahii Infection with Combination Therapy of Voriconazole and Liposomal Amphotericin B in a Child with Acute Lymphoblastic Leukemia: A Case Report

Background: Trichosporon species (particularly T. asahii) is regarded as one of the prevalent fungal species responsible for causing invasive fungal infection in patients with hematological malignancies and/or immunocompromised patients. Trichosporonosis can often be life-threatening; therefore, an early diagnosis followed by prompt treatment is crucial for the patient’s survival. However, an ideal antifungal treatment for T. asahii infection is not yet established. Case Presentation: This report presented a case of T. asahii fungemia in a male child of age ۵-year ۵ months with acute lymphoblastic leukemia. The patient developed febrile neutropenia towards the end of induction chemotherapy, and his blood culture indicated the presence of T. asahii and E. coli. He was treated with broad-spectrum antibiotics and antifungal monotherapy (either liposomal amphotericin B or voriconazole) without an effective outcome. Subsequently, the patient further underwent combination therapy with voriconazole and liposomal amphotericin B. Conclusion: Combination therapy with voriconazole and liposomal amphotericin B was found to improve the condition of the patient. He is currently reported to be fine while undergoing maintenance chemotherapy along with voriconazole monotherapy

Keywords:

Amphotericin B , Antifungal Agents , Chemotherapy , Febrile Neutropenia , T. asahii , voriconazole.