{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T15:51:20Z","timestamp":1782489080076,"version":"3.54.5"},"reference-count":18,"publisher":"BMJ","issue":"4","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,3,12]]},"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:p>\n                    Fungal infections are increasingly observed in immunocompromised patients, with non-Candida yeasts such as\n                    <jats:italic>Trichosporon asahii<\/jats:italic>\n                    emerging as significant opportunistic pathogens.\n                    <jats:italic>T. asahii<\/jats:italic>\n                    is a basidiomycetous yeast capable of causing disseminated disease in profoundly immunosuppressed hosts, particularly those with haematological malignancies or receiving cellular therapies. Diagnosis is often challenging due to morphological similarities with Cryptococcus and the limited sensitivity of conventional methods, while treatment is complicated by intrinsic resistance to echinocandins and high mortality despite azole therapy.\n                  <\/jats:p>\n                  <jats:p>\n                    We report a fatal case of disseminated\n                    <jats:italic>T. asahii<\/jats:italic>\n                    infection in a woman in her 50s with refractory diffuse large B-cell lymphoma undergoing chimeric antigen receptor T-cell therapy. On day 8 post-infusion, she developed hypoxia, haemodynamic instability and acute renal failure requiring intensive care. Bronchoscopy revealed exophytic right main bronchial lesions, and\n                    <jats:italic>T. asahii<\/jats:italic>\n                    was isolated from bronchoalveolar lavage and blood cultures. Despite early voriconazole therapy, the patient died of septic shock.\n                  <\/jats:p>","DOI":"10.1136\/bcr-2025-269040","type":"journal-article","created":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T15:10:15Z","timestamp":1775229015000},"page":"e269040","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Fatal invasive\n                    <i>Trichosporon asahii<\/i>\n                    infection with exophytic bronchial lesions in a patient with lymphoma undergoing CAR T-cell therapy"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5779-6597","authenticated-orcid":false,"given":"Elisabeth","family":"Paramythiotou","sequence":"first","affiliation":[{"name":"Critical Care, National and Kapodistrian University of Athens General Hospital of Athens Laiko, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evanthia","family":"Pappa","sequence":"additional","affiliation":[{"name":"Critical Care, National and Kapodistrian University of Athens General Hospital of Athens Laiko, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-3185-3942","authenticated-orcid":false,"given":"Vasiliki","family":"Iliadi","sequence":"additional","affiliation":[{"name":"Microbiology Department, National and Kapodistrian University of Athens General Hospital of Athens Laiko, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pavlos","family":"Vernikos","sequence":"additional","affiliation":[{"name":"Critical Care, National and Kapodistrian University of Athens General Hospital of Athens Laiko, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,4,3]]},"reference":[{"key":"2026062608152575000_19.4.e269040.1","doi-asserted-by":"crossref","DOI":"10.1017\/S0950268820001624","article-title":"Epidemiological study of Trichosporon asahii infections over the past 23 years","volume":"148","author":"Li","year":"2020","journal-title":"Epidemiol Infect"},{"key":"2026062608152575000_19.4.e269040.2","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00003-11"},{"key":"2026062608152575000_19.4.e269040.3","article-title":"A case of fatal invasive Trichosporonosis in the setting of immunosuppression and post-COVID-19 pneumonia","volume":"15","author":"Lopacinski","year":"2023","journal-title":"Cureus"},{"key":"2026062608152575000_19.4.e269040.4","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2017-07-793760"},{"key":"2026062608152575000_19.4.e269040.5","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1016\/j.cmi.2025.10.005","article-title":"Invasive fungal infections after CAR T-cell therapy for B-cell lymphoma: insights from the French DESCAR-T registry","volume":"32","author":"Bouvier","year":"2026","journal-title":"Clin Microbiol Infect"},{"key":"2026062608152575000_19.4.e269040.6","doi-asserted-by":"crossref","DOI":"10.1084\/jem.20230903","article-title":"CAR-T cell manufacturing: major process parameters and next-generation strategies","volume":"221","author":"Ayala Ceja","year":"2024","journal-title":"J Exp Med"},{"key":"2026062608152575000_19.4.e269040.7","first-page":"844","article-title":"Difficulties with diagnosing Trichosporon infections: Cryptococcus-like antigen cross-reactivity and polymorphic culture.","volume":"63","author":"Alanio","year":"2020","journal-title":"Mycoses"},{"key":"2026062608152575000_19.4.e269040.8","doi-asserted-by":"crossref","DOI":"10.3390\/jof9020236","article-title":"Pulmonary histoplasmosis: a clinical update","volume":"9","author":"Barros","year":"2023","journal-title":"J Fungi (Basel)"},{"key":"2026062608152575000_19.4.e269040.9","doi-asserted-by":"crossref","DOI":"10.1093\/ofid\/ofae133","article-title":"The burden of invasive fungal disease following chimeric antigen receptor T-cell therapy and strategies for prevention","volume":"11","author":"Little","year":"2024","journal-title":"Open Forum Infect Dis"},{"key":"2026062608152575000_19.4.e269040.10","doi-asserted-by":"crossref","DOI":"10.1128\/JCM.01505-18","article-title":"Invasive infections due to Trichosporon: species distribution, genotyping, and antifungal susceptibilities from a multicenter study in China","volume":"57","author":"Guo","year":"2019","journal-title":"J Clin Microbiol"},{"key":"2026062608152575000_19.4.e269040.11","doi-asserted-by":"publisher","DOI":"10.1016\/j.fgb.2009.03.003"},{"key":"2026062608152575000_19.4.e269040.12","doi-asserted-by":"publisher","DOI":"10.2217\/fmb.13.116"},{"key":"2026062608152575000_19.4.e269040.13","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2019004000"},{"key":"2026062608152575000_19.4.e269040.14","first-page":"1856","article-title":"Molecular identification and antifungal susceptibility profiles of clinical Trichosporon isolates: comparison of phenotypic and genotypic methods","volume":"11","author":"Arastehfar","year":"2020","journal-title":"Front Microbiol"},{"key":"2026062608152575000_19.4.e269040.15","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(21)00203-6"},{"key":"2026062608152575000_19.4.e269040.16","doi-asserted-by":"crossref","DOI":"10.1093\/ofid\/ofv141","article-title":"Epidemiology and outcome of Trichosporon fungemia: a review of 185 reported cases from 1975 to 2014","volume":"2","author":"Liao","year":"2015","journal-title":"Open Forum Infect Dis"},{"key":"2026062608152575000_19.4.e269040.17","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkab085"},{"key":"2026062608152575000_19.4.e269040.18","first-page":"e01508","article-title":"TAC1b mutation in Candida auris decreases manogepix susceptibility owing to increased CDR1 expression","volume":"69","author":"Hirayama","year":"2024","journal-title":"Antimicrob Agents Chemother"}],"container-title":["BMJ Case 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