Chronic subcutaneous infection of Purpureocillium lilacinum in an immunocompromised patient: Case report and review of the literature

Robin, Albert; Lemaignen, Adrien; Désoubeaux, Guillaume; Bailly, Éric; Bernard, Louis; Lacasse, Marion

doi:10.1016/j.mmcr.2022.08.001

Cited by 5 publications

(7 citation statements)

References 16 publications

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“…Ulcerations are the result of angioinvasion, in both humans and mice. Even though some of the lesions can be dramatic and extensive, they are usually completely asymptomatic [39,41]. Skin infections are mostly located on the lower limbs, reinforcing the theory of skin being the inoculation site.…”

Section: Cutaneous Infectionsmentioning

confidence: 97%

“…Due to the ubiquitous distribution of P. lilacinum in the environment, there are multiple possible modes of infection [41]. The most frequent infection sites are the skin, subcutaneous tissue, and eyes, although it can spread through the bloodstream, causing infections in various organs, such as the lungs, sinuses, and CNS [9].…”

Section: Pathogenesismentioning

confidence: 99%

“…Skin infections are mostly located on the lower limbs, reinforcing the theory of skin being the inoculation site. Most skin infections are not accompanied by general symptoms, such as a fever or malaise [41]. The latest reports point out that P. lilacinum infections of the lower limbs in immunocompromised patient can be easily mistaken for typical bacterial cellulitis, caused by Streptococcus and Staphylococcus, and P. lilacinum is usually suspected only after the patient is unresponsive to antibiotic therapy [11].…”

Section: Cutaneous Infectionsmentioning

confidence: 99%

“…In doubtful cases, it is advisable to confirm the diagnosis with MALDI-TOF mass spectrometry, DNA sequencing, or polymerase chain reaction (PCR) amplification of the 18 S RNA [40]. Identifying the exact fungus is of utmost importance due to the major differences in the sensitivity to antifungal agents within the same species, with an example being Purpureocilium lilacinum vs. P. variotti [41]. Additionally, when a disseminated disease is suspected, imaging techniques should be performed to assess the severity of the disease.…”

Section: Diagnosismentioning

confidence: 99%

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Cutaneous Hyalohyphomycosis and Its Atypical Clinical Presentations in Immunosuppressed Patients

Ferara,

Špoljar,

Lugović-Mihić

et al. 2024

Life

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There has been a substantial increase in the number of cases of invasive fungal infections worldwide, which is associated with a growing number of immunosuppressed patients and a rise in antifungal resistance. Some fungi that were previously considered harmless to humans have become emerging pathogens. One of them is Purpureocillium lilacinum, a ubiquitous filamentous fungus commonly found in the environment, especially in the air and soil. P. lilacinum belongs to a bigger group of hyaline fungi that cause hyalohyphomycosis, a fungal infection caused by fungi with colorless hyphae. Although this is a heterogeneous group of fungi, there are similarities regarding their ubiquity, ways of transmission, affected patients, and difficulties in diagnostics and treatment. In hyalohyphomycosis, the skin is one of the most affected organs, which is why the involvement of dermatologists is crucial for the initial assessment, since the timely recognition and early diagnosis of this condition can prevent life-threatening infections and death. In this review, we covered cutaneous hyalohyphomycosis caused by P. lilacinum and other fungi in the same group, including Fusarium, Penicilium, Scedosporium, Scopulariopsis, Acremonium, and Trichoderma genera.

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Section: Cutaneous Infectionsmentioning

confidence: 97%

Section: Pathogenesismentioning

confidence: 99%

Section: Cutaneous Infectionsmentioning

confidence: 99%

Section: Diagnosismentioning

confidence: 99%

See 2 more Smart Citations

Cutaneous Hyalohyphomycosis and Its Atypical Clinical Presentations in Immunosuppressed Patients

Ferara,

Špoljar,

Lugović-Mihić

et al. 2024

Life

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“…These cases were found in both immunocompetent and immunocompromised populations, most commonly in the skin but exceedingly rarely in the lungs[ 2 , 3 ]. While there are no standardized treatments for P. lilacinum infection, there are reports of high resistance to amphotericin B and fluconazole and good sensitivity to second-generation triazoles[ 4 , 5 ]. Herein, we reported a case of pulmonary infection caused by P. lilacinum successfully treated with isavuconazole, and reviewed the relevant literature.…”

Section: Introductionmentioning

confidence: 99%

Successful treatment of Purpureocillium lilacinum pulmonary infection with isavuconazole: A case report

Yang,

Zhang,

Ren

2024

World J Clin Cases

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BACKGROUND Purpureocillium lilacinum (P. lilacinum ) is a saprophytic fungus widespread in soil and vegetation. As a causative agent, it is very rarely detected in humans, most commonly in the skin. CASE SUMMARY In this article, we reported the case of a 72-year-old patient with chronic lymphocytic leukemia who was admitted with cough and fever. Computed tomography revealed an infection in the right lower lobe. Bronchoalveolar lavage fluid culture and metagenomic next-generation sequencing were ultimately confirmed to have a pulmonary infection with P. lilacinum . She was eventually discharged with good outcomes after treatment with isavuconazole. CONCLUSION Pulmonary infection with P. lilacinum was exceedingly rare. While currently there are no definitive therapeutic agents, there are reports of high resistance to amphotericin B and fluconazole and good sensitivity to second-generation triazoles. The present report is the first known use of isavuconazole for pulmonary P. lilacinum infection. It provides new evidence for the characterization and treatment of clinical P. lilacinum lung infections.

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Immunosuppressants/Posaconazole

2022

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Chronic subcutaneous infection of Purpureocillium lilacinum in an immunocompromised patient: Case report and review of the literature

Cited by 5 publications

References 16 publications

Cutaneous Hyalohyphomycosis and Its Atypical Clinical Presentations in Immunosuppressed Patients

Cutaneous Hyalohyphomycosis and Its Atypical Clinical Presentations in Immunosuppressed Patients

Successful treatment of Purpureocillium lilacinum pulmonary infection with isavuconazole: A case report

Immunosuppressants/Posaconazole

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