{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T13:37:08Z","timestamp":1785418628061,"version":"3.56.0"},"reference-count":20,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T00:00:00Z","timestamp":1777248000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"crossref","award":["82502794"],"award-info":[{"award-number":["82502794"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]},{"award":["82502794"],"award-info":[{"award-number":["82502794"]}],"id":[{"id":"https:\/\/ror.org\/01h0zpd94","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JoF"],"abstract":"<jats:p>Background: Trichosporon japonicum is a rare but highly lethal pathogen causing fungemia in immunocompromised patients. With the expanding use of chimeric antigen receptor T (CAR-T) cell therapy, the spectrum of opportunistic fungal infections is changing, yet data on T. japonicum infections in this setting remain scarce. Case Presentation: A 69-year-old man with diffuse large B-cell lymphoma developed catheter-associated fungemia after CAR-T cell reinfusion. He initially presented with neck pain and white oral mucosal patches, followed by fever four days later. T. japonicum was isolated from both peripheral blood and central venous catheter tip cultures, identified by microscopic examination, mass spectrometry, and molecular sequencing. Antifungal prophylaxis was initiated before fever onset based on close monitoring of white blood cell count, procalcitonin, interleukin-6, and C-reactive protein; treatment was subsequently adjusted according to species identification and antifungal susceptibility results. Infection was controlled within two weeks after catheter removal and immune recovery. The patient remained well at six-month follow-up. Conclusion: This case adds to the limited literature on T. japonicum fungemia in patients receiving CAR-T therapy. Our experience, together with a review of the literature, underscores that successful management requires prompt catheter removal, immune restoration, and combination therapy with voriconazole and amphotericin B, as echinocandin monotherapy should be avoided. Awareness of this pathogen in immunocompromised patients is critical.<\/jats:p>","DOI":"10.3390\/jof12050320","type":"journal-article","created":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T09:55:39Z","timestamp":1777370139000},"page":"320","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Catheter-Associated Trichosporon japonicum Fungemia in a Patient with Diffuse Large B-Cell Lymphoma Following CAR-T Cell Therapy: A Case Report and Literature Review"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1542-7288","authenticated-orcid":false,"given":"Liyan","family":"Mao","sequence":"first","affiliation":[{"name":"Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaozhen","family":"Yan","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Tian","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cui","family":"Jian","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yue","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ziyong","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9345-6140","authenticated-orcid":false,"given":"Zhongju","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"536","DOI":"10.4103\/ijmm.IJMM_19_146","article-title":"Epidemiology and Antifungal Susceptibility of Infections Caused by Trichosporon Species: An Emerging Non-Candida and Non-Cryptococcus Yeast Worldwide","volume":"37","author":"Singh","year":"2019","journal-title":"Indian. J. Med. Microbiol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e375","DOI":"10.1016\/S1473-3099(21)00203-6","article-title":"Global guideline for the diagnosis and management of rare yeast infections: An initiative of the ECMM in cooperation with ISHAM and ASM","volume":"21","author":"Chen","year":"2021","journal-title":"Lancet Infect. Dis."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Kourti, M., and Roilides, E. (2022). Invasive Trichosporonosis in Neonates and Pediatric Patients with Malignancies or Hematologic Disorders. Pathogens, 11.","DOI":"10.20944\/preprints202201.0255.v1"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"104616","DOI":"10.1016\/j.micpath.2020.104616","article-title":"Distribution of invasive fungal infections: Molecular epidemiology, etiology, clinical conditions, diagnosis and risk factors: A 3-year experience with 490 patients under intensive care","volume":"152","author":"Shamsaei","year":"2021","journal-title":"Microb. Pathog."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e169","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":"ref_6","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1007\/s11046-025-00969-z","article-title":"Trichosporon and Antifungal Resistance: Current Knowledge and Gaps","volume":"190","author":"Miranda","year":"2025","journal-title":"Mycopathologia"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"130","DOI":"10.7883\/yoken.JJID.2008.130","article-title":"Two possible cases of Trichosporon infections in bone-marrow-transplanted children- the first case of T. japonicum isolated from clinical specimens","volume":"61","author":"Bilgen","year":"2008","journal-title":"Jpn. J. Infect. Dis."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Albitar-Nehme, S., Agosta, M., Kowalska, A.H., Mancinelli, L., Onori, M., Lucignano, B., Mattana, G., Quagliarella, F., Cefalo, M.G., and Merli, P. (2022). Case Report: Trichosporon japonicum Fungemia in a Pediatric Patient With Refractory Acute B Cell Lymphoblastic Leukemia. Front. Pediatr., 10.","DOI":"10.3389\/fped.2022.861476"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"4026","DOI":"10.1128\/AAC.49.10.4026-4034.2005","article-title":"Susceptibility patterns and molecular identification of Trichosporon species","volume":"49","author":"Mellado","year":"2005","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1791","DOI":"10.1128\/JCM.02222-08","article-title":"Molecular Identification and Susceptibility of Trichosporon Species Isolated from Clinical Specimens in Qatar: Isolation of Trichosporon dohaense Taj-Aldeen, Meis & Boekhout sp. nov","volume":"47","author":"Meis","year":"2009","journal-title":"J. Clin. Microbiol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"141","DOI":"10.3109\/13693780902977984","article-title":"Molecular identification, genotyping, and drug susceptibility of the basidiomycetous yeast pathogen Trichosporon isolated from Turkish patients","volume":"48","author":"Kalkanci","year":"2010","journal-title":"Med. Mycol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"ofz343","DOI":"10.1093\/ofid\/ofz343","article-title":"Trichosporon japonicum Fungemia and Ventricular Assist Device Infection in an Immunocompetent Patient","volume":"6","author":"Bongomin","year":"2019","journal-title":"Open Forum Infect. Dis."},{"key":"ref_13","first-page":"307","article-title":"Molecular Identification, Genotyping, Phenotyping, and Antifungal Susceptibilities of Medically Important Trichosporon, Apiotrichum, and Cutaneotrichosporon Species","volume":"185","author":"Monteiro","year":"2020","journal-title":"Mycopathologia"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"ofaa365","DOI":"10.1093\/ofid\/ofaa365","article-title":"Urinary Tract Infections Caused by Fluconazole-Resistant Trichosporon japonicum in 2 Kidney Transplant Patients and Analysis of Their Homology","volume":"7","author":"Li","year":"2020","journal-title":"Open Forum Infect. Dis."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"918","DOI":"10.1111\/myc.13306","article-title":"MALDI-TOF MS characterisation, genetic diversity and antifungal susceptibility of Trichosporon species from Iranian clinical samples","volume":"64","author":"Ahangarkani","year":"2021","journal-title":"Mycoses"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Menu, E., Kabtani, J., Roubin, J., Ranque, S., and L\u2019Ollivier, C. (2022). Pericardial Effusion Due to Trichosporon japonicum: A Case Report and Review of the Literature. Pathogens, 11.","DOI":"10.3390\/pathogens11050598"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1007\/s11046-023-00723-3","article-title":"Identification of Clinical Trichosporon asteroides Strains by MALDI-TOF Mass Spectrometry: Evaluation of the Bruker Daltonics Commercial System and an In-House Developed Library","volume":"188","author":"Francisco","year":"2023","journal-title":"Mycopathologia"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1007\/s11046-021-00558-w","article-title":"Production of Secreted Carbohydrates that Present Immunologic Similarities with the Cryptococcus Glucuronoxylomannan by Members of the Trichosporonaceae Family: A Comparative Study Among Species of Clinical Interest","volume":"186","author":"Almeida","year":"2021","journal-title":"Mycopathologia"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1425","DOI":"10.1099\/00207713-48-4-1425","article-title":"Trichosporon japonicum sp. nov. isolated from the air","volume":"48","author":"Sugita","year":"1998","journal-title":"Int. J. Syst. Bacteriol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1277","DOI":"10.2217\/fmb-2021-0048","article-title":"Insight into the antifungals used to address human infection due to Trichosporon spp.: A scoping review","volume":"16","author":"Malacrida","year":"2021","journal-title":"Future Microbiol."}],"container-title":["Journal of Fungi"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2309-608X\/12\/5\/320\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T04:21:40Z","timestamp":1778559700000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2309-608X\/12\/5\/320"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,27]]},"references-count":20,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,5]]}},"alternative-id":["jof12050320"],"URL":"https:\/\/doi.org\/10.3390\/jof12050320","relation":{},"ISSN":["2309-608X"],"issn-type":[{"value":"2309-608X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,27]]}}}