Trichosporon asahii Infection in a Patient with Metastatic Prostate Cancer as an Example of an Emerging Fungal Pathogen.

CLINICAL HISTORY PATIENT: 59-year-old white man.

CHIEF COMPLAINT: Nausea, constant urge to urinate, and intermittent lower back pain that wraps around his right iliac crest and down his right anterior thigh to the level of his right knee.

HISTORY OF PRESENT ILLNESS: The patient sought radiation oncology consultation for his metastatic prostate cancer. He has had nephrostomy tubes and ureteral stents implanted to help with his bilateral uropathic manifestations. Two days earlier, his ureteral stent was removed and sent for culture during the replacement of his malfunctioning nephrostomy tubes; Trichosporon asahii had been cultured from the stent.

PREVIOUS MEDICAL HISTORY: Castration-resistant prostate cancer with bone metastasis, left upper abdominal shingles, recurrent urinary tract infections (UTIs), chronic anemia due to chemotherapy, and obstructive bilateral uropathy.

FAMILY HISTORY: Mother had breast cancer and father had lung cancer and heart disease.

PHYSICAL EXAMINATION FINDINGS: The patient was alert and oriented. There was a small, soft, compressible nodule, or cyst, in the posterior supraclavicular region. His lungs were clear, and his pulse had a regular rate and rhythm.

PRINCIPLE LABORATORY FINDINGS: Table 1.