Vulvovaginal Trichosporonosis

[摘要] Objective:Isolation ofTrichosporonspecies from vaginal secretions is a rare event, and no data are available onits pathogenic role. A case series is presented to determine the pathogenic role ofTrichosporonspecies invulvovaginal infections.Methods:We performed a retrospective chart review of patients seen in the W.S.U. Vaginitis Clinic in orderto identify patients from whomTrichosporonspecies were isolated.Results:Between 1986 and 2001, a total of 13 patients had a total of 18 positive vaginal cultures forTrichosporonspecies. All 18 vaginal isolates wereT. inkin. In general, positive vaginal cultures were accompanied by lowyeast colony counts. Four out of 18 positiveT. inkincultures were obtained from visits by asymptomatic patients.Of the remaining 14 positiveT. inkincultures from patients with symptoms, nine out of 14 cultures had otherdiagnoses (Candida albicans, six cases; bacterial vaginosis, two cases;Trichomonas, one case). Five positiveT. inkincultures were obtained from visits at which patients had symptoms and no associated diagnosis. In only one of thefive episodes could we establish a clear pathogenic role forTrichosporon. In this case the patient was treated withboric acid and had resolution of symptoms and a negative culture at follow-up.In-vitrosusceptibility tests revealedthatT. inkinwas resistant to flucytosine and susceptible to all topical and oral azoles.Conclusions:T. inkinis occasionally found in vulvovaginal cultures and is usually a non-pathogen. Transientcolonization tended to occur in women, usually of African—American origin, with major perturbations in vaginalflora (bacterial vaginosis and trichomoniasis) and increased pH. Pathogenic consequences ofTrichosporoncolonizationappear to be rare.

[学科分类] 妇产科学