Trichosporon fungal mediastinitis after cardiac surgery in a paediatric patient.

We report a case of Trichosporon austroamericanum mediastinitis in a 4-month-old male infant after repair of total anomalous pulmonary venous return. The causative organism was identified by genetic sequence analysis. Despite standard debridement and negative-pressure wound therapy, positive cultures persisted. Daily irrigation plus voriconazole therapy was required to achieve culture negativity. Chest closure was performed using omental filling, and the infant recovered without recurrence, underscoring the unique challenges of fungal mediastinitis.