Invasive Trichosporonosis: A diagnostic challenge in a patient with newly diagnosed HIV and multisystemic deterioration— The role of bone marrow aspirate

Trichosporon spp. are an emerging yeast capable of causing invasive infections, rarely reported in people living with HIV, in which the presentation can mimic classic opportunistic infections. We present a 38-year-old man with acute retroviral syndrome, pancytopenia, neurological impairment, and interstitial pneumonia. Head CT scan, lumbar puncture, and blood cultures were negative; an early bone marrow aspiration revealed fungal elements compatible with Trichosporon asahii, later confirmed by MALDI-TOF. This special article highlights the value of bone marrow aspiration as an early diagnostic tool in disseminated mycosis with negative cultures and emphasises Trichosporon spp. as a clinical imitator of classic opportunistic infections in patients who live with HIV.