# Trichosporon asahii and Candida guilliermondii as a Source of Orbital Infection in an Immunocompromised Individual

## TL;DR

A rare case of orbital infection caused by two fungi in an immunocompromised patient was successfully treated with antifungal therapy.

## Contribution

Reports a rare clinical case of orbital infection due to Trichosporon asahii and Candida guilliermondii in an immunocompromised individual.

## Key findings

- Trichosporon asahii and Candida guilliermondii were isolated from blood and venous samples.
- Antifungal therapy with amphotericin B and isavuconazole led to clinical improvement.
- Long-term consolidation therapy maintained clinical stability without recurrence.

## Abstract

A 47-year-old male with a history of immunosuppression and recent intensive care unit admission presented with progressive orbital swelling and pain. Blood cultures grew Trichosporon asahii and Candida guilliermondii, with matching positive cultures from peripheral and central venous samples. Given his fungemia and worsening orbital involvement, induction therapy with amphotericin B and isavuconazole was initiated. Within weeks, clinical improvement was noted, prompting a transition to long-term consolidation therapy with oral posaconazole and isavuconazole. At follow-up, the patient demonstrated sustained clinical stability with no recurrence of infection. Orbital involvement from fungemia due to T. asahii and C. guilliermondii is rare, and management requires early recognition, aggressive antifungal therapy, and careful monitoring.