Cutaneous Mycosis Caused by Paecilomyces lilacinus

Takayasu, Susumu; Akagi, Masashi; Shimizu, Yoko

doi:10.1001/archderm.1977.01640120055008

Cited by 45 publications

(17 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Only four other Paecilomyces infections were reported to occur in immunocompetent hosts. Takayasu et al 4 . reported an infection occurring in an otherwise healthy 20‐year‐old Japanese woman who presented with a 15‐year history of scaly papules and plaques on her left cheek initially diagnosed as lupus vulgaris.…”

Section: Discussionmentioning

confidence: 99%

Cutaneous hyalohyphomycosis caused by Paecilomyces lilacinus: report of three cases and review of the literature

et al. 2004

View full text Add to dashboard Cite

Cutaneous infection with Paecilomyces lilacinus is encountered worldwide, with most infections occurring either iatrogenically or in immunocompromised hosts. We report three cases of cutaneous hyalohyphomycosis caused by P. lilacinus, one of which occurred in an immunocompetent individual. In addition, we review the 17 cases previously reported in the literature. Although this infection can be difficult to treat, most cases are not fatal. Most cases responded well to systemic azole antifungal agents, either alone or in association with surgical excision of the lesion. Paecilomyces species are saprophytic fungi found in soil and decaying organic matter. Infection in humans is rare, but when it occurs treatment is often difficult. We report three cases of cutaneous hyalohyphomycosis caused by P. lilacinus and review the 17 previously reported cases in which the clinical history and response to therapy were described.

show abstract

Section: Discussionmentioning

confidence: 99%

Cutaneous hyalohyphomycosis caused by Paecilomyces lilacinus: report of three cases and review of the literature

et al. 2004

View full text Add to dashboard Cite

show abstract

“…1 The genus was described in 1907 3 and P. lilacinus , originally classified as a Penicillium sp., was assigned to the genus Paecilomyces in 1974. 2 There are few reported culture‐proven cases of P. lilacinus as a cause of cutaneous disease, 4–13 several of these also being in immunosuppressed individuals 4–6,8 , 9,11–13 . Cutaneous infections have been described in renal transplant patients, 4,5 , 8 and a liver transplant recipient with multiple skin lesions due to P. lilacinus was reported by Hecker et al .…”

Section: Discussionmentioning

confidence: 99%

Cutaneous hyalohyphomycosis caused by Paecilomyces lilacinus in a renal transplant patient

Blackwell

Ahmed

O’Docherty

et al. 2000

British Journal of Dermatology

View full text Add to dashboard Cite

show abstract

“…In 1977, a 20‐year‐old immunocompromised woman had a 14‐year history of facial cellulitis that partially responded to oral griseofulvin. 3 In 1979, a renal transplant patient with cellulitis was successfully treated with intravenous miconazole. 4 In 1986, P. lilacunis was the etiologic agent in a patient with cellulitis and draining sinusitis and chronic lymphocytic lymphoma who responded to amphotericin and 5‐fluorocystine.…”

Section: Discussionmentioning

confidence: 99%

Cutaneous Paecilomyces lilacunis infection in a hospitalized patient taking corticosteroids

Marchese

Smoller

1998

Int J Dermatology

View full text Add to dashboard Cite

A 72‐year‐old Caucasian man presented with tender, hyperkeratotic, violaceous, ill‐defined, scattered plaques associated with minimal pitting edema of the right upper extremity. He had been discharged 3 days earlier from an outlying community hospital after a 33‐day admission for exacerbation of chronic obstructive lung disease requiring large doses of systemic corticosteroids. A right subclavian central venous line for intravenous access was placed after he developed a gastrointestinal bleed and myocardial infarction. The clinical differential diagnosis of the eruption on the right upper extremity at the time he presented to our service included cellulitis, deep venous thrombosis, and brachial plexus neuropathy. Brachial plexus neuropathy was ruled out with normal electromyography, nerve conduction studies, and cervical spine radiographs. Deep venous thrombosis was never completely eliminated, because the patient refused a venogram and the venous Doppler exam was nondiagnostic. Treatment for a presumed bacterial cellulitis was initiated with Nafcillin intravenously. As there was clinical disease progression without appreciable improvement by day nine ( Fig. 1 and 2), a skin biopsy was performed and topical Nystatin powder was added for possible yeast etiology. Bacterial cultures were negative; however, fungal cultures on Sabouraud’s agar were positive for Paecilomyces lilacunis after 15 days. Histologic sections demonstrated skin with an essentially normal epidermis. Within the dermis, there was an extensive, mixed, granulomatous inflammatory infiltrate with abundant multinucleated giant cells. Necrosis was not abundant. Occasional 8–12 μm yeast‐like organisms were apparent within the cytoplasm of multinucleated cells and in an extracellular location, together with occasional hyphal forms with irregular branching. Periodic acid–Schiff (PAS) with diastase and Gomori methenamine silver accentuated the staining and confirmed the fungal nature of the organisms ( Fig. 3). The histologic differential included various other fungi. Cryptococcus is usually smaller, endospores characteristic of coccidiomycosis were not present, and a thick capsule usually seen in blastomycosis was not observed in these organisms. The diagnosis of Paecilomyces lilacunis was established, and itraconazole 200 mg orally twice a day was instituted. Clinical improvement as measured by decreased edema, increased range of motion, and resolution of cutaneous lesions was dramatic during the first week. Itraconazole was decreased to 200 mg a day and the patient continued to improve. He was discharged to home. He has followed up in our clinic every month with complete resolution to date 7 months after discharge. 1 Right upper extremity demonstrating violaceous hue, edema, and scale taken after 9 days of Nafcillin. Note progression of disease to involve the left upper extremity 3 Gomori methenamine silver stain reveals multiple 8–12 μm organisms. Original magnification, 400×

show abstract

Cutaneous Mycosis Caused by Paecilomyces lilacinus

Cited by 45 publications

References 9 publications

Cutaneous hyalohyphomycosis caused by Paecilomyces lilacinus: report of three cases and review of the literature

Cutaneous hyalohyphomycosis caused by Paecilomyces lilacinus: report of three cases and review of the literature

Cutaneous hyalohyphomycosis caused by Paecilomyces lilacinus in a renal transplant patient

Cutaneous Paecilomyces lilacunis infection in a hospitalized patient taking corticosteroids

Contact Info

Product

Resources

About