Fungemia due to Trichosporon asahii in a neutropenic child refractory to amphotericin B: clearance with voriconazole.

Disseminated Trichosporon infection in neutropenic patients carries a poor prognosis. Clinical evidence on the use of voriconazole for this infection is limited. The authors report a case of Trichosporon asahii fungemia refractory to liposomal amphotericin B treatment in a boy with acute lymphoblastic leukemia, which resolved after the addition of voriconazole. Both voriconazole and amphotericin B exhibited low minimal inhibitory concentrations and minimal fungicidal concentrations, and their combination was indifferent in vitro. The use of voriconazole for the treatment of trichosporonosis in patients with hematologic malignancies deserves further study.