Abstract
Trichosporon species cause wide varieties of fungal infections. White piedra, a superficial fungal infection on the hair shaft, is caused by Trichosporon species. We report here a case of white piedra over the scalp due to T. inkin, a rarely isolated pathogen from such a lesion. The identification of the fungus was confirmed on the basis of morphology, carbohydrate assimilation tests, and sequencing of the ITS region of rDNA. The available literature on infections due to T. inkin is also reviewed.
References
Gueho E, Improvisi L, de Hoog GS, Dupont B. Trichosporon on humans: a practical account. Mycoses. 1994;37:3–10.
Therizol-Ferly M, Kombila M, Gomez de Diaz M, Duong TH, Richard-Lenoble D. White piedra and Trichosporon species in equatorial Africa. I. History and clinical aspects: an analysis of 449 superficial inguinal specimens. Mycoses. 1994;37:249–53.
Taj-Aldeen SJ, Al-Ansari HI, Boekhout T, Theelen B. Co-isolation of Trichosporon inkin and Candida parapsilosis from a scalp white piedra case. Med Mycol. 2004;42:87–92.
Clinical and Laboratory Standards Institute (formerly NCCLS). Reference method for broth dilution antifungal susceptibility testing of yeast; approved standard. CLSI document. 3rd edn. USA: CLSI; 2008.
Hay RJ, Moore MK. Mycology. In: Burns T, Breathnach S, Cox N, Griffiths C, editors. Rook’s textbook of dermatology 7th edn. London: Blackwell Science; 2004. p. 31.16–8.
Basu N, Sanyal M, Banerjee AK, Thammayya A. White piedra in India. Ind J Dermatol Venereol Leprol. 1970;36:154–5.
Pankajalaxmi VV, Taralaxmi VV, Paramasivan CN. Trichosporon beigelii infection in Tamilnadu. Indian J Dermatol Venereol Leprol. 1979;45:136–8.
Marquis L. Fungi, fragile, fastidious, fascinating (CME). Indian J Dermatol Venereol Leprol. 1986;52:251–61.
Pasricha JS, Nigam PK, Banerjee U. White piedra in Delhi. Indian J Dermatol Venereol Leprol. 1990;56:56–7.
Khandpur S, Reddy BS. Itraconazole therapy for white piedra affecting scalp hair. J Am Acad Dermatol. 2002;47:415–8.
Kiken DA, Sekaran A, Antaya RJ, Davis A, Imaeda S, Silverberg NB. White piedra in children. J Am Acad Dermatol. 2006;55:956–61.
Tambe SA, Dhurat SR, Kumar CA, Thakare P, Lade N, Jerajani H, et al. Two cases of scalp white piedra caused by Trichosporon ovoides. Indian J Dermatol Venereol Leprol. 2009;75:293–5.
Girmenia C, Pagano L, Martino B, D’Antonio D, Fanci R, Specchia G, et al. Invasive infections caused by Trichosporon species and Geotrichum capitatum in patients with hematological malignancies: a retrospective multicenter study from Italy and review of the literature. J Clin Microbiol. 2005;43:1818–28.
Padhye AA, Verghese S, Ravichandran P, Balamurugan G, Hall L, Padmaja P, et al. Trichosporon loubieri infection in a patient with adult polycystic kidney disease. J Clin Microbiol. 2003;41:479–82.
Chagas-Neto TC, Chaves GM, Melo AS, Colombo AL. Bloodstream infections due to Trichosporon spp.: species distribution, Trichosporon asahii genotypes determined on the basis of ribosomal DNA intergenic spacer 1 sequencing, and antifungal susceptibility testing. J Clin Microbiol. 2009;47:1074–81.
Chagas-Neto TC, Chaves GM, Colombo AL. Update on the genus Trichosporon. Mycopathologia. 2008;166:121–32.
de Hoog GS, Guarro J, Gene J, Figueras MJ. Atlas of medically important fungi. The Netherlands: Central Beaureu Voor Schimmelcultures; 2003.
Rodriguez-Tudela JL, Diaz-Guerra TM, Mellado E, Cano V, Tapia C, Perkins A, et al. Susceptibility patterns and molecular identification of Trichosporon species. Antimicrob Agents Chemother. 2005;49:4026–34.
Sugita T, Nishikawa A, Ikeda R, Shinoda T. Identification of medically relevant Trichosporon species based on sequences of internal transcribed spacer regions and construction of a database for Trichosporon identification. J Clin Microbiol. 1999;37:1985–93.
Kenney RT, Kwon-Chung KJ, Witebsky FG, Melnick DA, Malech HL, Gallin JI. Invasive infection with Sarcinosporon inkin in a patient with chronic granulomatous disease. Am J Clin Pathol. 1990;94:344–50.
Wynne SM, Kwon-Chung KJ, Shea YR, Filie AC, Varma A, Lupo P, et al. Invasive infection with Trichosporon inkin in 2 siblings with chronic granulomatous disease. J Allergy Clin Immunol. 2004;114:1418–24.
Piwoz JA, Stadtmauer GJ, Bottone EJ, Weitzman I, Shlasko E, Cummingham-Rundles C. Trichosporon inkin lung abscesses presenting as a penetrating chest wall mass. Pediatr Infect Dis J. 2000;19:1025–7.
Madariaga MG, Tenorio A, Proia L. Trichosporon inkin peritonitis treated with caspofungin. J Clin Microbiol. 2003;41:5827–9.
Crowther KS, Webb AT, McWhinney PH. Trichosporon inkin peritonitis in a patient on continuous ambulatory peritoneal dialysis returning from the Caribbean. Clin Nephrol. 2003;59:69–70.
Moretti-Branchini ML, Fukushima K, Schreiber AZ, Nishimura K, Papaiordanou PM, Trabasso P, et al. Trichosporon species infection in bone marrow transplanted patients. Diagn Microbiol Infect Dis. 2001;39:161–4.
Davies F, Logan S, Johnson E, Klein JL. Sternal wound infection by Trichosporon inkin following cardiac surgery. J Clin Microbiol. 2006;44:2657–9.
Chaumentin G, Boibieux A, Piens MA, Douchet C, Buttard P, Bertrand JL, et al. Trichosporon inkin endocarditis: short-term evolution and clinical report. Clin Infect Dis. 1996;23:396–7.
Ramos JM, Cuenca-Estrella M, Gutierrez F, Elia M, Rodriguez-Tudela JL. Clinical case of endocarditis due to Trichosporon inkin and antifungal susceptibility profile of the organism. J Clin Microbiol. 2004;42:2341–4.
Goodman D, Pamer E, Jakubowski A, Morris C, Sepkowitz K. Breakthrough trichosporonosis in a bone marrow transplant recipient receiving caspofungin acetate. Clin Infect Dis. 2002;35:E35–6.
Walsh TJ, Groll A, Hiemenz J, Fleming R, Roilides E, Anaissie E. Infections due to emerging and uncommon medically important fungal pathogens. Clin Microbiol Infect. 2004;10(Suppl 1):48–66.
Pontes ZB, Ramos AL, Lima Ede O, Guerra Mde F, Oliveira NM, Santos JP. Clinical and mycological study of scalp white piedra in the State of Paraiba, Brazil. Mem Inst Oswaldo Cruz. 2002;97:747–50.
Lopes JO, Alves SH, Klock C, Oliveira LT, Dal Forno NR. Trichosporon inkin peritonitis during continuous ambulatory peritoneal dialysis with bibliography review. Mycopathologia. 1997;139:15–8.
Mussa AY, Singh VK, Randhawa HS, Khan ZU. Disseminated fatal trichosporonosis: first case due to Trichosporon inkin. J Mycol Med. 1998;8:196–9.
Koyanagi T, Nishida N, Osabe S, Imamura Y, Yamamoto S, Shichiji A, et al. Autopsy case of disseminated Trichosporon inkin infection identified with molecular biological and biochemical methods. Pathol Int. 2006;56:738–43.
Song HJ, Chung SL, Lee KS. Trichosporon inkin subcutaneous infection in a rheumatoid arthritis patient. Int J Dermatol. 2007;46:282–3.
David C, Martin DB, Deng A, Cooper JZ. Disseminated Trichosporon inkin and Histoplasma capsulatum in a patient with newly diagnosed AIDS. J Am Acad Dermatol. 2008;59:S13–5.
Magalhaes AR, Mondino SS, Silva M, Nishikawa MM. Morphological and biochemical characterization of the etiological agents of white piedra. Mem Inst Oswaldo Cruz. 2008;103:786–90.
Acknowledgments
The authors would like to thank Mrs. Sunita Gupta for her excellent technical support and Indian Council of Medical Research, New Delhi, India, for their support in purchasing the sequencer for the Centre of Advance Research in Medical Mycology.
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Shivaprakash, M.R., Singh, G., Gupta, P. et al. Extensive White Piedra of the Scalp Caused by Trichosporon inkin: A Case Report and Review of Literature. Mycopathologia 172, 481–486 (2011). https://doi.org/10.1007/s11046-011-9454-2
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DOI: https://doi.org/10.1007/s11046-011-9454-2