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Aug 2011

Papular Eruption in a Patient With Leukemia —Diagnosis

Author Affiliations
 

SECTION EDITOR: MARY S. STONE, MD; ASSISTANT SECTION EDITORS: SOON BAHRAMI, MD; CARRIE ANN R. CUSACK, MD; SENAIT W. DYSON, MD; MOLLY A. HINSHAW, MD; ARNI K. KRISTJANSSON, MD

Arch Dermatol. 2011;147(8):975-980. doi:10.1001/archdermatol.2011.196-b

The biopsy specimens revealed numerous elongated septate hyphal forms in the subcutis and in thrombi within vessels of the subdermal plexus that were highlighted on special staining. On tissue culture, Trichosporon loubieri was identified by 16S ribosomal sequencing. The patient's blood cultures and the tip of her peripherally inserted central catheter also yielded T loubieri.

Trichosporon species are ubiquitous in the environment, found in decomposing wood and soil. They are also transiently found as colonizers of the skin and respiratory and gastrointestinal tracts. Formerly, Trichosporon beigelli, the cause of white piedra, was the only member of the genus until molecular analysis allowed reclassification into multiple species, several of which have been shown to cause invasive infections in immunocompromised patients. Inaddition to benign superficial mycoses, Trichosporon species have been implicated in allergic pneumonia and invasive fungemia leading to endocarditis and hepatic and cerebral abscesses. Invasive infections are often catheter related and occur more commonly in patients with hematologic malignancies and neutropenia.1

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