Trichosporon asahii fungemia and COVID-19 co-infection: An emerging fungal pathogen; case report and review of the literature

•Trichosporon asahii fungemia is an emerging invasive pathogen in critically ill Coronavirus disease 2019 patients.•Judicious use of immunosuppressant medications is advisable in critically ill Coronavirus disease 2019.•Periodically fungal surveillance program is recommended in critically ill COVID-19 patients.•Voriconazole is the first option of therapy for Trichosporon asahii infection. With the evolving COVID-19 pandemic, increasing concerns about invasive fungal infections have been reported particularly with the use of potent immunosuppressant medications to treat the immunological storms in patients with severe COVID-19 illnesses. Trichosporon asahii (T. asahii) is an emerging highly resistant pathogen with considerable mortality particularly in critically ill patients and immunocompromised individuals. We describe a case of a 58-year-old patient who developed T. asahii fungemia after using immunosuppressant agents for his severe COVID-19 related cytokines release syndrome. Pseudohyphae, arthroconidia, and lateral blastoconidia were seen in the stain, and later confirmed to be T. asahii. Voriconazole successfully treated this multi-drug-resistant fungal infection. The clinical presentation, assessment, and management are reviewed to raise awareness of the circumstances leading to coinfection with this emerging resistant yeast.