Short communication Trichosporon asahii fatal infection in a non-neutropenic patient after orthotopic liver transplantation Abstract: Trichosporon asahii is a yeast that may cause systemic infection, especially in neutropenic patients. To our knowledge, only two cases of invasive infection with Trichosporon were previously described in liver transplant recipients.We describe an additional case of T. asahii infection after orthotopic liver transplantation in a non-neutropenic patient who had no known risk factor for invasive fungal infection, and died in spite of amphotericin B therapy. Invasive fungal infections (IFIs) represent a signi¢cant cause of morbid- ity in patients submitted to orthotopic liver transplantation (OLT), with a high mortality rate (1^3). Candida sp., Cryptococcus sp., and Aspergillus sp. are the most frequent pathogens (1, 2). Trichosporonosis has recently been recognized as an emerging group of life-threatening infections in immunocompromised patients, primarily neutropenic patients (4^6).To our knowledge, only two cases of systemic Trichosporon infection after OLT have been previously described (7, 8). We report an unusual case of a systemic fatal infection withTrichosporon asahii after OLT in a non-neutropenic patient. Case report A 51-year-old woman received an OLT for primary biliary cirrhosis on September 12, 1993. Surgical prophylaxis consisted of ampicillin and ce- fotaxime. She received cyclosporine, azathioprine, and prednisone as im- munosuppressive therapy. On September 21,1993, she su¡ered from acute rejection, which was treated with an intravenous pulse of methylpredni- solone, 1 g/day for 3 days. In October 1995, chronic myelocytic leukemia (CML) was diagnosed and treated with hydroxyurea (1g/day PO) and subcutaneous interferon-a (5,000,000 UI/day for 6 months). Prednisone Key words: Trichosporon asahii; trichosporonosis; compromised host; opportunistic infection; liver transplant recipient E. Abdala R.I. Lopes C.N. Chaves E.M. Heins-Vaccari M.A. Shikanai-Yasuda Received 26 January 2005, revised 17 August 2005, accepted for publication 23 August 2005 Copyright & Blackwell Munksgaard 2005 Transplant Infectious Disease . ISSN 1398-2273 Transpl Infect Dis 2005: 7: 162^165 Printed in Denmark. All rights reserved Authors’a⁄liations: E. Abdala 1,2 , R.I. Lopes 1 , C.N. Chaves 1 , E.M. Heins-Vaccari 2 , M.A. Shikanai-Yasuda 2 1 Liver Transplantation Division, Department of Surgery, 2 Department of Infectious and Parasitic Diseases, University of Saì o Paulo Medical School, Saì o Paulo, Brazil Correspondence to: Edson Abdala Av. Itabora|¤ , 311 Ap.24 Bosqueda Sau¤ de Saì oPaulo, SP 04135-000 Brazil Tel: 155 11 55896515 Fax: 155 11 30667270 e-mail: eabdala@uol.com.br 162