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The basidiomycetous yeast Trichosporon may cause severe lung exacerbation in cystic fibrosis patients - clinical analysis of Trichosporon positive patients in a Munich cohort.
[allergic bronchopulmonary aspergillosis]
The
relevance
of
Trichosporon
species
for
cystic
fibrosis
(
CF
)
patients
has
not
yet
been
extensively
investigated
.
The
clinical
course
of
CF
patients
with
Trichosporon
spp
.
in
their
respiratory
secretions
was
analysed
between
2003
and
2010
in
the
Munich
CF
center
.
All
respiratory
samples
of
360
CF
patients
(
0
-
52
.
4
years
;
mean
FEV
1
2010
81
.
4
%
pred
)
were
investigated
.
In
8
patients
(
2
.
2
%
,
3
male
,
mean
age
21
.
8
years
)
Trichosporon
was
detected
at
least
once
.
One
patient
carried
T
.
asahii
.
One
patient
carried
T
.
mycotoxinivorans
and
one
patient
T
.
inkin
as
determined
by
DNA
sequencing
.
As
potential
risk
factors
for
Trichosporon
colonization
steroid
treatment
,
allergic
bronchopulmonary
aspergillosis
(
ABPA
)
and
CF
associated
diabetes
were
identified
in
6
,
5
,
and
2
patients
respectively
.
For
one
patient
,
the
observation
period
was
not
long
enough
to
determine
the
clinical
course
.
One
patient
had
only
a
single
positive
specimen
and
exhibited
a
stable
clinical
course
determined
by
change
in
forced
expiratory
volume
in
one
second
(
FEV
1
)
,
body-mass-index
(
BMI
)
,
C-
reactive
protein
(
CRP
)
and
immunoglobulin
G
(
IgG
)
.
Of
6
patients
with
repeatedly
positive
specimen
(
mean
detection
period
4
.
5
years
)
,
4
patients
had
a
greater
decline
in
FEV
1
than
expected
,
2
of
these
a
decline
in
BMI
and
1
an
increase
in
IgG
above
the
reference
range
.
2
patients
received
antimycotic
treatment
:
one
patient
with
a
tormenting
dry
cough
subjectively
improved
under
Amphotericin
B
inhalation
;
one
patient
with
a
severe
exacerbation
due
to
T
.
inkin
was
treated
with
i
.
v
.
Amphotericin
B
,
oral
Voriconazole
and
Posaconazole
which
stabilized
the
clinical
condition
.
This
study
demonstrates
the
potential
association
of
Trichosporon
spp
.
with
severe
exacerbations
in
CF
patients
.
Diseases
Validation
Diseases presenting
"allergic bronchopulmonary aspergillosis"
symptom
allergic bronchopulmonary aspergillosis
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