key: cord-0962233-bpum1y29
authors: Segrelles-Calvo, Gonzalo; Araújo, Glauber R. De S.; Llopis-Pastor, Estefanía; Frasés, Susana
title: Trichosporon asahii as cause of nosocomial pneumonia in patient with COVID-19: A triple co-infection
date: 2020-12-01
journal: Arch Bronconeumol
DOI: 10.1016/j.arbres.2020.11.007
sha: 7c2b2bef285995bc6c8ff7b5eb384a49ea20d219
doc_id: 962233
cord_uid: bpum1y29

nan

Trichosporon asahii have been identified in neutropenic cancer patients, which significantly increased 45 the severity of their cases leading to a high mortality rate. Recently, the infection has also been 46 identified in other groups of immunocompromised patients [5] . 47

Here, we report a case of an immunocompetent patient suffering from a severe case of COVID-48 19 infection who also developed a triple pulmonary coinfection with Pseudomonas sp., 49

Stenotrophomonas sp. and Trichosporon sp. 50

The patient reported in this study was a 58-year-old male patient that, in 2000, presented a mild 51 chronic kidney disease and had a tuberculosis infection treated with isoniazid chemoprophylaxis. In 52 2004, he was diagnosed with a bladder neoplasm and was submitted to a radical cystoprostatectomy 53 and a left nephrectomy due to a renal metastasis. The patient had been free of malignant disease for 54 the past ten years and had a competent immune status. 55

The patient went to the emergency room (Figure 1 -Day 1) after presenting, for twelve days, 56 high fever, unproductive cough, and general affection. Twenty-four hours before going to the hospital, lymphopenia (900 / mm 3 ), high C-Reactive Protein (CRP = 35 mg/dL), and altered transaminases 59 The incidence of invasive infections caused by opportunistic fungal species has increased in 94 recent decades. These fungi are normally difficult to diagnose, resistant to many antifungals, and are 95 associated with high mortality rates [8]. In the 1980s, the invasive Trichosporon infection was 96 considered the second most common cause of fungemia among immunosuppressed patients who also 97 suffered from hematological diseases, hemochromatosis, end-stage renal disease, or who were on a 98 long-term corticosteroid treatment. Depending on the age, underlying conditions, presence of 99 neutropenia, and clinical treatments, the mortality rates of patients suffering from an invasive 100 tricosporonosis infection can range from 30% to 90% [9-11]. Until now, our case is the first report 101 that shows a Trichosporon infection in a COVID-19 patient. 102

The present study was approved by the Ethics Committee of the Fundación Jiménez Díaz 142

Health Research Institute (EO102-20-HRJC). Due to the pandemic situation, informed consent was 143 not requested from the patients. Personal information and data obtained from the subjects were kept 144 confidential. 

Pulmonary pathology and COVID-19: Lessons 112 from autopsy. The experience of European Pulmonary Pathologists

Severe acute respiratory syndrome 114

SARS-CoV-2) and coronavirus disease-2019 (COVID-19): The epidemic and 115 the challenges

Epidemiological and clinical characteristics of 99 cases of 117 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study

Burden of serious fungal 120 infections in Spain

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Fungal co-infections associated with global COVID-19 pandemic: 126 A clinical and diagnostic perspective from China

Update on the Genus Trichosporon

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Fungemia: A review of 185 reported cases from 1975 to 2014

The authors declare that they have no known competing financial interests or personal 148 relationships that could have appeared to influence the work reported in this paper. 149