VEENAA MANJARI S1, INDHUMATHI E1, PREMAMALINI T2, JAYAKUMAR M1
1Department of Nephrology, Sri Ramachandra Institute Of Higher Education And Research, Chennai, India, 2Department of Microbiology, Sri Ramachandra Institute of Higher Education and Research, Chennai, India
BACKGROUND: Fungal infections of arteriovenous (AV) grafts are rare. So far only Candidal infections have been reported. Here we present an unusual fungal infection of AV graft.
CASE REPORT: A 52 years old male on maintenance hemodialysis presented with fever. A non-erythematous, non-tender swelling was noted in graft site. Doppler showed pseudoaneurysm and ligation was planned. During surgery, graft was found to be infected & removed. Infected AV graft culture & blood culture yielded Trichosporon mycotoxinivorans, which has not been reported so far. He was treated with amphotericin B and voriconazole and recovered.
CONCLUSION: We believe this to be the first case of AV graft infection with Trichosporon species which was successfully treated with removal of the graft and antifungal therapy. Invasive trichosporonosis is associated with high mortality rate. Patients with trichosporonosis should be monitored carefully and antifungal therapy should be continued until patient is afebrile and clinically stable.
I am a nephrology resident in Sri Ramachandra Institute of Higher Education and Research, Chennai, India.