Identification of causative fungus from sterilized or bacteriostatic abscess using metagenomics followed by in situ hybridization

We present a case report of breakthrough invasive trichosporonosis in a patient with acute myeloid leukemia (AML) receiving antifungal prophylaxis. Blood culture and liver biopsy initially failed to identify Trichosporon asahii, which was eventually detected by metagenomic next-generation sequencing and in-situ hybridization using a DNA probe.