Three new cases of systemic mycosis due to Trichosporon cufaneum are reported and compared with the 23 previous reports. Two patients had acute leukemia and one patient had a lymphoblastic lymphoma. Blood cultures in two patients and cerebrospinal fluid in the third patient were positive for T. cufaneum. Only one patient recovered after antimycotic therapy and concomittent remission of his leukemia. At autopsy, the two other patients showed widespread infection with T. cufaneum. The authors conclude that diagnosis and management of such infection in the immunosuppressed host are difficult and the prognosis is poor. Cancer 58:2399-2405, 1986. RICHOSPORON BEIGELII, formerly known as Trichos-T poron cutaneum, is an arthrospore forming yeast of the class Deuteromycetes (fungi imperfecti) and the family Cryptococcaceae. T. cutaneum is an inhabitant of the soil, but is occasionally found in normal human skin, sputum, and urine. It may cause white piedra, a superficial mycosis involving the hair.
Twenty-three cases of invasive T. cutaneum have been reported.'-17 Although these infections occurred mainly in patients with acute leukemia, a few were seen after removal of a cataract,18 replacement of heart valve^,^^^,'^ and treatment with immunosuppressive drugs.
We describe three new cases of disseminated T. cutaneum. Of special interest are the apparent cure with am- photericin B in one patient, and, in another, meningeal involvement not previously reported.
Case Reports
Case I A 5 I-year-old white man was admitted to the intensive care unit in June 1984 for a medullary relapse of lymphoblastic lymphoma. He was treated with cytosine arabinoside, vincristine, rubidazone, prednisone, and weekly intrathecal injections of methotrexate (for prophylactic purposes). Before these injections,