Aspectos clínicos y patogénicos de la infección profunda por Trichosporon asahii

• Main Authors: Suárez-Álvarez Paola, Puello-Hoyos Marta, Mendoza-Ballestas Ketty
• Format: Article
• Language: Spanish
• Published: Universidad de Cartagena 2013-12-01
• Series: Revista Ciencias Biomédicas
• Subjects: Mycoses; Trichosporon; Fungemia; Immune System; Opportunistic Infections.
• Online Access: http://revistacienciasbiomedicas.com/index.php/revciencbiomed/article/view/295/238

Introduction: trichosporon beigelii was considered as the only species of the genus for long time; it was recognized because it was the causal agent of a mycosis of the hair named “White piedra”. The taxonomy of the genus has changed and about thirteen species have been described which are involved in human diseases. T. inkin, T. cutaneum, T. mucoides, T. asteroides, T. ovoides and T. asahii are six species that have been associated to located or disseminated infections. Objective: to revise the available information about Trichosporon spp and to identify the impact that have T. asahii as pathogenic agent. Methods: a bibliographic search in Pubmed was carried out, getting together the obtained data in the program for the bibliographic management Endnote X1. Complete articles, abstracts of original researches and reviews were borne in mind. Results: the main causal agent of deep trichosporonosis is the T. asahii. This yeast has been associated to skin and systemic infections. The infection appears in conditions with immunological compromise: Cancer, chronic disease or disorders in the cutaneous and mucous barriers. In general, it is considered that the routes of entry could be catheters, drainage tubes, and lack of continuity of skin in burned patients and by move from the intestinal mucous. Six genotypes of T. asahii have been described. They have global distribution and the predominance is for the genotype-1. The process of pathogenesis of the trichosporonosis is determined by the immunological condition of the patient and the virulence factors of the agent. The presence of glucuronoxylomannan has been indicated as possible virulence factor. The diagnosis is done with metabolic and molecular tests. The treatment of the deep trichosporonosis is ineffective if the immunodeficiency does not excel itself. The resistance is increasing to amphotericin b and other antifungal drugs. Better results are obtained with Voriconazole. Conclusions: the deep trichosporonosis by T. asahii is an emergent fungal disease that affects specially to neutropenic patients. The diagnosis is a challenge and the mortality rate is high. Rev.cienc.biomed. 2013;4(2):327-334