ArticleEuropean journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology2025
Cryptococcal antigen cross-reactivity is associated with fatal trichosporonosis in patients with hematologic diseases.
Article in European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- First report of bloodstream infection caused byFrontiers in cellular and infection microbiology · 2025Article
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Funding
Abstract
purposeInvasive trichosporonosis is an emerging, life-threatening fungal infection in immunocompromised patients with hematologic diseases. The lack of reliable diagnostic biomarkers makes early diagnosis challenging, hindering prompt and effective management.
methodsWe conducted a retrospective single-center study of 88 patients with positive Trichosporon cultures, identified from a cohort of 6,169 inpatients with hematologic diseases at a tertiary medical center from 2004 to 2023. Trichosporon species were identified using matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF). We investigated the risk factors, clinical characteristics, and outcomes of invasive trichosporonosis in the patient population.
resultsProlonged corticosteroid treatment and broad-spectrum antibiotic use were associated with an increased risk of developing invasive trichosporonosis. Invasive trichosporonosis presented as a breakthrough infection in 58.5% of cases, predominantly during echinocandin therapy. Second-generation triazole therapy, particularly voriconazole, was associated with improved outcomes. Cryptococcal antigen cross-reactivity was significantly associated with fatal outcomes in our cohort.
conclusionInvasive trichosporonosis frequently manifests as a breakthrough infection during echinocandin therapy, often leading to fatal outcomes in hematologic patients. Early initiation of second-generation triazole therapy is crucial. Cryptococcal antigen cross-reactivity may be a useful diagnostic tool, as well as a prognostic marker, in invasive trichosporonosis. Although this cross-reactivity poses diagnostic challenges if misinterpreted, it offers an opportunity for early diagnosis and prompt initiation of appropriate antifungal therapy.
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