ABSTRACT
Trichosporon beigelii is an uncommon cause of sepsis in low-birth-weight infants. We present two cases
of neonatal trichosporonosis and two cases of neonatal trichosporon colonization to
familiarize neonatologists with this entity and to discuss management considerations.
A 23-week-gestation male developed clinical evidence of sepsis on day 10 and was found
to have “yeast” growing in a blood culture on day 12. Despite receiving amphotericin
B, he expired within 2 days, at which time the organism was identified as T. beigelii. A 23-week-gestation female developed fungal septicemia in the second week of life,
while being treated for persistent bacterial sepsis. Candida albicans grew from blood
culture, while T. beigelii grew from suprapubic urine, tracheal aspirate, and umbilical catheter tip cultures.
She died 2 days later despite therapy with amphotericin B, at which time the fungal
isolates were correctly identified. Two other infants were found to have colonization
of central vascular catheters, without evidence of invasive disease. Trichosporon
infections in neonates have been almost uniformly fatal. Most strains of T. beigelii are relatively resistant to amphotericin B and may be confused with Candida sp. on initial culture examinations. Therefore, delays in appropriate treatment may
occur. We discuss treatment options, including alternative antifungal drugs, as well
as possibilities for combination therapy.
Keywords
Trichosporon beigelii - fungal infection - neonate
