Disseminated Trichosporonosis Presenting with Acute Emphysematous Pyelonephritis in Severely Comorbid Patient

Abstract

Trichosporon asahii is a basidiomycetous yeast, which is a rare and life-threatening pathogen and is invariably associated
with disseminated trichosporonosis. Presented here is the report of a successfully treated case of a 74-year-old female with
disseminated trichosporonosis who presented with acute emphysematous pyelonephritis complicated with septic plus
cardiogenic shock and septic acute renal failure and heart failure stage ‘C’ with ischemic heart disease, diabetes mellitus
type 2, hypertension. She was admitted in our hospital with complaints of high-grade fever, abdominal pain, nausea,
vomiting, giddiness, burning micturition, difficulty in breathing since 1 week. CT scan KUB showed acute emphysematous
pyelonephritis and blood culture and urine culture showed growth of T. asahii. Antifungal susceptibility testing was done
and the pathogen was found sensitive to voriconazole, fluconazole and amphotericin B. Patient responded well to intravenous
voriconazole and improved completely in such severely comorbid condition. Disseminated trichosporonosis is a very rare
disease with mortality rate as high as 70%, especially in severely comorbid patient.