Complicated Trichosporon asahii mastoiditis in immunocompetent child

Background Trichosporon asahii is an opportunistic fungus that causes infections in immunosuppressed patients. It is rarely seen in children and immunocompetent hosts. The mortality rates are still high despite early treatment with proper antifungal drugs. Trichosporon asahii mastoiditis in an immunocompetent child makes this case challenging. Case presentation This report presents a case of Trichosporon asahii mastoiditis which was complicated by transverse sinus thrombosis, in an otherwise healthy 21-month-old girl, and successfully treated with voriconazole. Trichosporon asahii was isolated, in three different occasions, from ear discharge of an immunocompetent healthy child, who presented with prolonged history of fever and received appropriate dosages of multiple types of antimicrobials as an outpatient but without improvement. After 48 h of starting the Voriconzole; post auricular swelling and ear discharge improved significantly. Conclusion A high index of clinical and microbiological suspicion is needed for optimal diagnosis of Trichosporon infection. Trichosporon asahii can also cause infection in immunocompetent individual even without previous history of hospitalization or intervention. We emphasize the importance of early pediatric infectious evaluation and intervention.

Acquiring accidental aspergillosis

Aspergillus is an all-pervasive mold with the potential to cause severe invasive infections in the immunocompromised. A rare cutaneous manifestation of Aspergillus infection, primary cutaneous aspergillosis (PCA), occurs in just 1-5% of invasive aspergillosis cases. Prompt treatment is indicated as PCA may progress to a disseminated state. We present a unique case of an immunocompetent individual diagnosed with PCA two weeks after trauma and subsequent surgery.

Coccidioidomycosis Meningitis in an Immunocompetent Worker: A Case Report

“If you work in the dry dust of Arizona or California central valley surely be warned about fever, or deadly head-aches from all those Cocci!!”. While pulmonary coccidiomycosis infections in the endemic places are seen very often, especially among immunocompromised people, CNS coccidiomycosis infection from environmental exposure in immunocompetent individual is not that common, but when it happens it is fatal. Risk is very high in certain occupations in endemic regions and the diagnosis may be challenging in absence of high clinical suspicions. Here, we report a case of coccidiomycosis meningitis in an immunocompetent individual, who went to Arizona for a week for his painting job. The purpose of this paper is to prevent the occupation-related dreaded incidence of fungal brain infection in endemic places with robust public health measures.