An Unusual Cause of Fever and Rash in a Child With Severe Aplastic Anemia

J Pediatr Hematol Oncol. 2018 Mar;40(2):156-158. doi: 10.1097/MPH.0000000000000876.

Abstract

A 4-year-old girl with severe aplastic anemia and 2 previous failed T-depleted haploidentical peripheral blood stem cell transplants developed persistent neutropenic fever and multiple erythematous maculopapular rashes 2 days after her third T-replete haploidentical bone marrow transplant. Skin biopsy confirmed the diagnosis of Trichosporon asahii infection. She was on caspofungin prophylaxis which is not effective against Trichosporon. A high index of suspicion, prompt investigation, and appropriate treatment with voriconazole for 4 months was instrumental in controlling the infection and she remains well presently 9 months posttransplant with full donor chimerism and free from infection.

Publication types

  • Case Reports

MeSH terms

  • Anemia, Aplastic / complications*
  • Anemia, Aplastic / therapy
  • Antifungal Agents / therapeutic use
  • Child, Preschool
  • Exanthema / immunology*
  • Exanthema / microbiology
  • Female
  • Fever / immunology*
  • Fever / microbiology
  • Hematopoietic Stem Cell Transplantation
  • Humans
  • Immunocompromised Host*
  • Trichosporonosis / drug therapy
  • Trichosporonosis / immunology*
  • Voriconazole / therapeutic use

Substances

  • Antifungal Agents
  • Voriconazole