Infections dues à Trichosporon spp. et à Geotrichum spp.

Seven human pathogenic Trichosporon species have been described: T. ovoides, T. inkin, T. ashaii, T. asteroides, T. cutaneum, T. mucoides and T. loubieri. These species are causative agents of superficial infections such as the white piedra and are involved in localized or disseminated deep infections. Disseminated trichosporonosis are involved particularly in neutropenic patients with underlying haematological malignancy. To date, there is no standard classification in the Geotrichum genus. Three species are described: G. candidum, G. clavatum and G. capitatum (synonymously listed as Blastomyces capitatus) which was originally known as Trichosporon capitatum. The pathogenicity of Geotrichum spp. has been documented in those localized and disseminated human deep infections that occur, most of the time, during episods of severe and prolonged neutropenia. On the basis of in vitro susceptibility data and case reports, combination therapy is recommended for Trichosporon and Geotrichum infections. Voriconazole, or high-dose fluconazole for susceptible strains, plus amphotericin B is now used for the treatment of these rare infections.