Trichosporon inkin as an Emergent Pathogen in Patients With Severe Pemphigus.

Nobrega de Almeida Júnior, João; Buccheri de Oliveira, Renata; Duarte, Amaro; Lopes Motta, Adriana; Rossi, Flávia; Sachiko Yamamoto de Figueiredo, Dulce; Barbaro Del Negro, Gilda Maria; Aoki, Valeria et al. · JAMA Dermatol · 2015

case_report · Level V

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Abstract

To our knowledge, these are the first reports of bloodstream infections by Trichosporon inkin in patients with pemphigus. Trichosporon inkin, a novel organism causing bloodstream infection, was detected in 2 patients with pemphigus. An elderly man with pemphigus foliaceus died despite treatment with liposomal amphotericin B, 3 mg/kg/d, and a young girl with pemphigus vulgaris responded to treatment with voriconazole, 8 mg/kg/d, for 24 days. One of the T inkin isolates had a minimal inhibitory concentration of 2 mg/L against amphotericin B, suggesting resistance to the drug. Delayed suspicion of invasive infection by T inkin may result in a poor outcome in patients with severe forms of pemphigus. This opportunistic infection is highly refractory to conventional potent antifungal treatment.

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