We report the first case of summer-type hypersensitivity pneumonitis(SHP) in Korea diagnosed by positive serum antibodies to Trichosporon cutaneum. Hypersensitivity pneumonitis(HP) has been commonly classified as an occupational respiratory diseases. However, evidence that sensitizing organisms can also contaminate and cause pulmonary diseases in home environment has been increasing. One such disease is SHP. In Japan, 75% of cases with HP are SHP. Even though there has been no known SHP case in Korea yet, there has been high possibility of SHPs in Korea because our country has areas which have hot and humid summer climate similar to Japan. This first case of SHP in Korea suggests that there may be another cases in Korea and nation-wide survey may be required. We report here the first confirmed case of SHP in Korea.
Antibodies ; Climate ; Hypersensitivity ; Japan ; Korea* ; Lung Diseases ; Trichosporon ; Trichosporonosis*

Since the report of disseminated trichosporonosis in 1970s, several cases of infection by various Trichosporon species in different clinical patients were published. We've isolated a strain of T. asahii from not only blood but also urine. We report 71 year-old male patient with Trichosporon asahii fungemia, who had renal stones. It was identified as T. asahii using conventional method and also confirmed by 18S rRNA gene sequencing. The patient was discharged without any complication, in which case only antibiotic agent was used without any antifungal one.
Fungemia* ; Genes, rRNA ; Humans ; Male ; Trichosporon* ; Trichosporonosis ; Urinary Tract Infections*

Trichosporon species now ranks as the second most common cause of disseminated yeast infections with a high mortality rate. Breakthrough trichosporonosis in patients receiving echinocandins therapy is being recognized recently. We present a case of breakthrough trichosporonosis with acute viral myocarditis while receiving caspofungin therapy. Trichosporon infection should be considered in patients, who have risk factors for invasive fungal infection and develop unexplained clinical manifestations of infection despite treatment with echinocandins.
Adult ; Antifungal Agents ; therapeutic use ; Echinocandins ; therapeutic use ; Female ; Humans ; Lipopeptides ; Treatment Outcome ; Trichosporonosis ; drug therapy ; microbiology

Trichosporon beigelii is a causative agent of white piedra, an superficial hair shaft infection in immunocompetent individuals, and rarely of disseminated trichosporonosis in immunocompromised patients especially in neutropenic patients with leukemia. Trichosporon infections in immunocompromised patients are frequently fatal despite therapy with amphotericin B. We describe an acute myelogenous leukemia patient with T. beigelii fungemia after remission induction chemotherapy who was successfully treated with amphotericin B and fluconazole.
Amphotericin B* ; Drug Therapy ; Fluconazole* ; Fungemia* ; Hair ; Humans ; Immunocompromised Host ; Leukemia ; Leukemia, Myeloid, Acute* ; Neutropenia ; Piedra ; Remission Induction ; Trichosporon* ; Trichosporonosis

Systemic infection due to Trichosporon beigelii is uncommon but increasingly reported in immunocompromised patients. Trichosporonosis is often refractory to conventional antifungal therapy and frequently fatal. We report a case of systemic T. beigelii infection in a patient with acute leukemia. The 35-year-old male patient had been diagnosed as acute myelogenous leukemia with severe neutropenia and received cytotoxic drug therapy. As a fever developed on the day 21 of chemotherapy, broad spectrum antibiotics were administered empirically. Even though an antifungal drug, amphotericin B was replaced because the blood cultures resulted in T. beigelii, the patient died of the septic shock. We think that T. beigelii should be included as a potential life-threatening pathogen capable of causing widespread systemic disease in the immunocompromised host.
Adult ; Amphotericin B ; Anti-Bacterial Agents ; Drug Therapy ; Fever ; Humans ; Immunocompromised Host ; Leukemia* ; Leukemia, Myeloid, Acute ; Male ; Neutropenia ; Shock, Septic ; Trichosporon* ; Trichosporonosis

INTRODUCTIONBecause invasive fungal infections cause significant morbidity and mortality in liver transplant recipients, the use of antifungal prophylaxis, and the early empirical use of antifungal agents, is widespread on liver transplant units. The new-generation azoles such as voriconazole and the echinocandins have been welcome additions to the antifungal armamentarium. These agents have become the leading options for prophylaxis in liver transplant units, despite the absence of strong data for their efficacy in this setting.

CLINICAL PICTUREWe report two recipients of living-donor liver transplants who became infected/colonised with fungi resistant to an echinocandin and the azoles after exposure to these agents. One patient developed trichosporonosis while on caspofungin and the other became infected/ colonised with Candida glabrata that was resistant to voriconazole and posaconazole.

CONCLUSIONWe report these to highlight some of the consequences of using the newer antifungal agents.

Adult ; Antifungal Agents ; therapeutic use ; Drug Resistance, Fungal ; Echinocandins ; therapeutic use ; Fatal Outcome ; Female ; Fluconazole ; therapeutic use ; Humans ; Lipopeptides ; Liver Transplantation ; adverse effects ; immunology ; Male ; Middle Aged ; Mycoses ; drug therapy ; prevention & control ; Pyrimidines ; therapeutic use ; Triazoles ; therapeutic use ; Trichosporonosis ; drug therapy ; prevention & control ; Voriconazole ; Young Adult