eMedicine Specialties > Infectious Diseases > Fungal Infections

Trichosporon Infections: Follow-up

Author: Tyler E Warkentien, MD, Fellow, Department of Infectious Diseases, Naval Medical Center, San Diego
Coauthor(s): Ryan C Maves, MD, Consulting Staff and Director, Bacteriology Program, United States Naval Medical Research Center Detachment, Lima, Peru; Braden R Hale, MD, MPH, Assistant Clinical Professor, Department of Internal Medicine, University of California at San Diego; Consulting Staff, Department of Internal Medicine, Division of Infectious Diseases, Naval Medical Center at San Diego
Contributor Information and Disclosures

Updated: Nov 4, 2009

Follow-up

Further Inpatient Care

  • Patients with trichosporonosis should be monitored carefully, preferably in the ICU, until recovery of an adequate neutrophil count. Continue active antifungal therapy during the period of neutropenia and after recovery of neutrophil count until the resolution of symptoms.
  • Monitor blood cultures, urine cultures, and cutaneous or ocular lesions, along with renal and hepatic panel blood chemistries.
  • CT scanning of the abdomen and pelvis is indicated in most patients for initial evaluation and should be periodically repeated to monitor the progress of disease. For example, the lesions of hepatosplenic disease may become visible only after recovery of neutrophils.
  • The patient should remain on therapy until clinically stable and afebrile with the resolution of all visceral lesions.

Prognosis

  • The prognosis of acute disseminated Trichosporon infection is poor, unless recovery of neutrophils occurs.
  • The prognosis of indolent or localized infection is better than that of disseminated disease.

Miscellaneous

Medicolegal Pitfalls

  • Relying on a primary regimen that contains only a single drug, as well as use of an echinocandin as monotherapy, may be problematic.
  • Failure to recognize the significance of clinical isolates of Trichosporon may represent a medicolegal pitfall.
  • Recognize that patients who survive trichosporonosis, particularly those with hepatosplenic involvement, may develop recurrent disease if the host immune system is suppressed again.
  • If only histologic tissue is used in the diagnosis of trichosporonosis, take great care in the interpretation of the results, since species identification can be difficult.
 


More on Trichosporon Infections

Overview: Trichosporon Infections
Differential Diagnoses & Workup: Trichosporon Infections
Treatment & Medication: Trichosporon Infections
Follow-up: Trichosporon Infections
References
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Further Reading

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Keywords

infections, white piedra, trichosporonosis, neutropenia

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Contributor Information and Disclosures

Author

Tyler E Warkentien, MD, Fellow, Department of Infectious Diseases, Naval Medical Center, San Diego
Tyler E Warkentien, MD is a member of the following medical societies: American College of Physicians, American Society for Microbiology, Armed Forces Infectious Diseases Society, and Infectious Diseases Society of America
Disclosure: Nothing to disclose.

Coauthor(s)

Ryan C Maves, MD, Consulting Staff and Director, Bacteriology Program, United States Naval Medical Research Center Detachment, Lima, Peru
Ryan C Maves, MD is a member of the following medical societies: American College of Physicians, American Society for Microbiology, Armed Forces Infectious Diseases Society, HIV Medicine Association of America, Infectious Diseases Society of America, and Phi Beta Kappa
Disclosure: Nothing to disclose.

Braden R Hale, MD, MPH, Assistant Clinical Professor, Department of Internal Medicine, University of California at San Diego; Consulting Staff, Department of Internal Medicine, Division of Infectious Diseases, Naval Medical Center at San Diego
Braden R Hale, MD, MPH is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians, Armed Forces Infectious Diseases Society, and Infectious Diseases Society of America
Disclosure: Nothing to disclose.

Medical Editor

Jeffrey M Zaks, MD, Clinical Associate Professor of Medicine, Wayne State University School of Medicine; Vice President, Medical Affairs, Chief Medical Officer, Department of Internal Medicine, Providence Hospital
Jeffrey M Zaks, MD is a member of the following medical societies: American College of Cardiology, American College of Healthcare Executives, American College of Physician Executives, and American Medical Association
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Thomas M Kerkering, MD, Chief of Infectious Diseases, Virginia Tech, Carilion School of Medicine, Roanoke, Virginia
Thomas M Kerkering, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians, American Public Health Association, American Society for Microbiology, American Society of Tropical Medicine and Hygiene, Infectious Diseases Society of America, Medical Society of Virginia, and Wilderness Medical Society
Disclosure: Nothing to disclose.

CME Editor

Eleftherios Mylonakis, MD, Clinical and Research Fellow, Department of Internal Medicine, Division of Infectious Diseases, Massachusetts General Hospital
Eleftherios Mylonakis, MD is a member of the following medical societies: American Association for the Advancement of Science, American College of Physicians, American Society for Microbiology, and Infectious Diseases Society of America
Disclosure: Nothing to disclose.

Chief Editor

Burke A Cunha, MD, Professor of Medicine, State University of New York School of Medicine at Stony Brook; Chief, Infectious Disease Division, Winthrop-University Hospital
Burke A Cunha, MD is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, and Infectious Diseases Society of America
Disclosure: Nothing to disclose.

 
 
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