# Voriconazole successfully treats intracranial Trichosporon asahii infection in an immunocompetent patient: a rare case report and literature review

## TL;DR

A rare case of intracranial fungal infection caused by Trichosporon asahii in an immunocompetent woman was successfully treated with voriconazole.

## Contribution

This is a rare case report of intracranial T. asahii infection in an immunocompetent patient successfully treated with voriconazole.

## Key findings

- T. asahii was identified as the causative agent of intracranial infection in an immunocompetent patient.
- Voriconazole treatment led to successful clinical outcomes after 15 days of administration.
- Early diagnosis and appropriate antifungal therapy are crucial for favorable prognosis in such cases.

## Abstract

Trichosporon asahii (T. asahii) has been increasingly recognized as the causative pathogen of invasive fungal infection, whereas intracranial infection caused by T. asahii are extremely scarce. Here, we report a rare case of intracranial T. asahii infection in an immunocompetent woman from China. She was hospitalized for obstructive hydrocephalus and experienced two brain surgeries. One week after the second surgery, the patient developed fever, vomiting, and elevated infection-related indicators. Cerebrospinal fluid (CSF) cultures yielded T. asahii and its morphology was demonstrated by Gram staining. The patient initially received empiric antifungal therapy with voriconazole (VCZ), and the subsequent drug sensitivity results supported the continuation of this therapy. Finally, 15 days of VCZ administration successfully achieved satisfactory therapeutic effects. This case highlights that T. asahii has emerged as an infectious cause of intracranial fungal infection in immunocompetent people. Early recognition and adequate antifungal treatment are paramount to ensure a favorable prognosis.