Environmental research at the patient’s home and multidisciplinal identification for Trichosporon asahii. Environmental research at the patients’ home showed tatami mats that were crumbled and in a decaying state with malodorous white matters beneath the mats (Panel A). On Sabouraud agar, multiple soft nodules of white piedra are cultured, suggesting Trichisporon asahii (Panel B). Light microscopy demonstrates the blue colored hyphae that disarticulate into rectangular arthroconidia with rounded ends (Panel C). Electron microscopy clearly depicts those rounded ends with size up to 5 μm (Panel D).