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

<i>Trichosporon asahii</i> (<i>T. asahii</i>) has been increasingly recognized as the causative pathogen of invasive fungal infection, whereas intracranial infection caused by <i>T. asahii</i> are extremely scarce. Here, we report a rare case of intracranial <i>T. asahii</i> 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 <i>T. asahii</i> 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 <i>T. asahii</i> 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.