[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Microbiology](https://durgical.com/en/microbiology/) › [Yeasts and yeast-like fungi](https://durgical.com/en/microbiology/groups/yeasts-and-yeast-like-fungi/) › Other opportunistic yeasts (Trichosporon, Rhodotorula, Saccharomyces)

# Other opportunistic yeasts (Trichosporon, Rhodotorula, Saccharomyces)

- Fungus
- For completeness

Uncommon yeasts that cause bloodstream infections in patients with cancer, catheters or probiotics. Some resist the usual antifungals.

Updated Nov 13, 2026

Also called: rare yeasts, Trichosporon asahii, Rhodotorula mucilaginosa, Saccharomyces cerevisiae, Saccharomyces boulardii

## Quick facts

**Type**
Fungus · [Yeasts and yeast-like fungi](https://durgical.com/en/microbiology/groups/yeasts-and-yeast-like-fungi/)

**Gram / shape**
Trichosporon

**Spread**
Endogenous · Central venous catheters

**Causes**
Trichosporon fungemia

**Treatment**
Trichosporon

On this page

- The basics Key points
- At a glance
- Morphology
- Transmission
- In Colombia
- Memory aid
- What the colours mean

- Clinical Virulence factors
- Diseases it causes
- Clinical picture
- Diagnosis

- Treatment Treatment
- Prevention

- Study Test yourself

- Connections Connections

## Key points

- Yeast in blood despite an echinocandin: think Trichosporon or Rhodotorula.
- Trichosporon: arthroconidia, voriconazole preferred, positive cryptococcal antigen by cross-reaction.
- Rhodotorula: orange-salmon colonies, catheter fungemia, treat with amphotericin B.
- Saccharomyces fungemia is linked to probiotics; stop them.

## At a glance

**Shape**
Trichosporon: blastoconidia, hyphae and rectangular arthroconidia; Rhodotorula and Saccharomyces: oval budding yeasts

**Family**
Trichosporon and Rhodotorula: Basidiomycota; Saccharomyces: Ascomycota

**Type**
Yeasts and yeast-like fungi

**Stain**
Gram or calcofluor; blood culture and identification by mass spectrometry or sequencing

## Morphology

- Trichosporon: cream, dry, wrinkled colonies; hyphae that break into arthroconidia.
- Rhodotorula: mucoid orange to salmon-colored colonies (carotenoid pigment).
- Saccharomyces: oval budding yeasts with ascospores, similar to Candida but without true hyphae.

## Transmission

- Endogenous: colonization of skin, gut or airway that enters the blood through mucosal damage.
- Central venous catheters (Rhodotorula especially).
- Probiotic capsules opened at the bedside contaminate hands and catheters (Saccharomyces); spread between patients by hands has caused outbreaks.

**Reservoir:** Soil, water, food and human skin and gut; Probiotic products (Saccharomyces boulardii)

### Isolation precautions

What the care team adds to standard precautions.

- Standard

## Virulence factors

- Biofilm on catheters and devices.
- Intrinsic resistance: Trichosporon and Rhodotorula are not killed by echinocandins, so they can break through while patients receive them.
- Trichosporon cell wall shares an antigen with Cryptococcus, which explains a positive cryptococcal antigen test.

## Diseases it causes

- Trichosporon fungemia and disseminated infection in hematologic malignancy and neutropenia, with skin nodules and high mortality. [Febrile neutropenia →](https://durgical.com/en/conditions/febrile-neutropenia/)
- Catheter-related fungemia by Rhodotorula, and probiotic-associated Saccharomyces fungemia in ICU and immunosuppressed patients. [Sepsis and septic shock →](https://durgical.com/en/conditions/sepsis-and-septic-shock/)
- Trichosporon also causes white piedra on hair and summer-type hypersensitivity pneumonitis in healthy people.

## Clinical picture

- Suspect them when a yeast grows from blood in a patient already receiving an echinocandin.
- In a Latin American review of rare yeasts, Trichosporon asahii was the most common species and fungemia the main presentation, with high crude mortality.
- Leukemia, central venous catheters, cancer, surgery and broad-spectrum antibiotics are the usual backgrounds.

## Diagnosis

- Blood cultures; identification to species by mass spectrometry or ITS sequencing (biochemical tests can mislabel them).
- Colony color is a clue: orange-salmon suggests Rhodotorula.
- Trichosporon can make the cryptococcal antigen and galactomannan tests positive.

## Treatment

Trichosporon: voriconazole is preferred; amphotericin B, echinocandins and flucytosine are not reliable. Rhodotorula: amphotericin B (with or without flucytosine); it resists echinocandins and azoles. Saccharomyces: amphotericin B or an echinocandin, stop the probiotic. Removing the catheter is part of treatment.

Drug class only; doses and regimens are set by the clinician from the current guideline.

In Pharmacology:

- [Voriconazole](https://durgical.com/en/pharmacology/voriconazole/)
- [Amphotericin B](https://durgical.com/en/pharmacology/amphotericin-b/)
- [Flucytosine](https://durgical.com/en/pharmacology/flucytosine/)
- [Echinocandins](https://durgical.com/en/pharmacology/classes/echinocandins/)

## Prevention

- Careful central-line care and early removal.
- Avoiding probiotics with live yeast in critically ill and immunosuppressed patients, and never opening capsules near catheters.
- Hand hygiene to prevent spread between patients.

## In Colombia

A 2023 Latin American review found few published cases from Colombia (mainly Trichosporon asahii, Rhodotorula mucilaginosa and Malassezia), most likely because these yeasts are underreported.

## Memory aid

«Trick, Rose and Beer»: Trick-osporon tricks the cryptococcal test, Rhodo- is rose colored, and the beer yeast Saccharomyces comes from probiotics; none trusts the echinocandins.

## Test yourself

Think of the answer, then tap the question to see it.

## A neutropenic patient on an echinocandin develops fungemia with a yeast that forms arthroconidia. What is the likely genus and preferred drug?

Trichosporon; voriconazole is preferred because echinocandins and amphotericin B are unreliable.

## Which rare yeast forms orange to salmon colonies and is almost always catheter-related?

Rhodotorula.

## What is the main risk factor for Saccharomyces fungemia?

Use of probiotics containing Saccharomyces (S. boulardii), especially with a central catheter.

## Why can Trichosporon cause a false-positive cryptococcal antigen test?

Its cell wall shares a polysaccharide antigen with Cryptococcus.

[Add to my cards (4)](https://durgical.app/estudiar/?add=/en/microbiology/other-opportunistic-yeasts/)

## What the colours mean

**Gram-positive**
Thick peptidoglycan wall: stains purple.

**Gram-negative**
Thin wall with an outer membrane: stains pink.

**Acid-fast**
Lipid-rich wall (mycobacteria): Ziehl–Neelsen stain.

## Connections

## Related 4

- [Candida albicans](https://durgical.com/en/microbiology/candida-albicans/)
- [Cryptococcus neoformans](https://durgical.com/en/microbiology/cryptococcus-neoformans/)
- [Malassezia](https://durgical.com/en/microbiology/malassezia/)
- [Agents of superficial mycoses (Hortaea werneckii, Piedraia hortae, Trichosporon)](https://durgical.com/en/microbiology/agents-of-superficial-mycoses/)

## Related conditions 2

- [Febrile neutropenia](https://durgical.com/en/conditions/febrile-neutropenia/)
- [Sepsis and septic shock](https://durgical.com/en/conditions/sepsis-and-septic-shock/)

[← Back to the group: Yeasts and yeast-like fungi](https://durgical.com/en/microbiology/groups/yeasts-and-yeast-like-fungi/)

Educational content on microorganisms; not a treatment guide and no substitute for a health professional's advice. No doses are given.

Sources: [Rare fungal infectious agents: a lurking enemy](https://pmc.ncbi.nlm.nih.gov/articles/PMC5664977/) (F1000Research (PMC), 2017); [Rare Yeasts in Latin America: Uncommon Yet Meaningful](https://pmc.ncbi.nlm.nih.gov/articles/PMC10381163/) (Journal of Fungi (PMC), 2023).

## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake

Representative model, for educational purposes only.

---
Source: https://durgical.com/en/microbiology/other-opportunistic-yeasts/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/microbiology/other-opportunistic-yeasts/