Thread by @IUIDfellowship

#idboardreview 70 M skin opening at pacemaker site with purulent chest wall drainage. No improvement on abx. Dx? #medEd #idmedEd #idtwitter

Culture of the swab of the lesion on the chest grew #Trichosporon beigelii

#Trichosporon beigelii yeast in soil & water. In humans, it colonizes skin, GI & GU. It cause superficial skin infections, such as white piedra. In immunocompromised hosts: deep invasive infections, including fungemia, endocarditis and chronic meningitis

#Trichosporon grow easily on routine fungal plates & appear creamy. Microscopic features include pseudohyphae, hyphae, blastoconidia (which differentiate it from Geotrichum) & arthroconidia (which differentiate it from Candida & can resemble arthroconidia of Coccidioides spp.

#Trichosporon spp. have variable susceptibility to azoles and amphotericin B, but consistently demonstrate high MIC to echinocandins

White piedra superficial fungal infections of hair #Trichosporon beigelii more common in tropics: soft concretions attached to scalp hair but can occur in axilla, pubis, beard. confused w/ nits but KOH masses of septate hyphae. Tx: clip/shave hair & topical ketoconazole

#trichosporon hypersensitivity pneumonitis immunocompetent host bmcresnotes.biomedcentral.com/articles/10.11…

Disseminated #trichosporonosis in immunocompromised host: fatal in 60% pts. Host: neutropenia/malignancy heme or SOT, hiv, catheter related. Skin: Multiple red papules. Typically S to voriconazole & posaconazole

#trichosporonosis ncbi.nlm.nih.gov/pmc/articles/P… @ASMicrobiology @FranciscoMarty_