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Zhou L, Qi X, Guo G, Wang Y, Yang J, Yang D, Huang S. Cutaneous hyphomycosis Caused by Purpureocillium lilacinus Infection Associated with Superficial Venipuncture: A Case Report. Clin Cosmet Investig Dermatol 2023; 16:2437-2441. [PMID: 37701060 PMCID: PMC10493128 DOI: 10.2147/ccid.s422290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Accepted: 09/03/2023] [Indexed: 09/14/2023]
Abstract
Cutaneous hyphomycosis caused by Purpureocillium lilacinus is a relatively uncommon event in patients, but there has been a gradual increase in reported cases. A 71-year-old female patient was hospitalized in May 2022 due to an acute episode of chronic obstructive pulmonary disease and received glucocorticoid infusion. The skin around the puncture point on the back of her right hand showed erythema, nodules, scabs, and pus discharge, which gradually worsened. Fungal examination revealed the presence of hyphae, while treatment with terbinafine was ineffective. After fungal culture, pathological analysis, and molecular biology identification techniques, this case was diagnosed as cutaneous and subcutaneous infections caused by Purpureocillium lilacinus. After 2 weeks of treatment with itraconazole, the patient recovered. Patients on long-term hormone preparations who undergo superficial venipuncture should be aware of the risk of skin damage and potential infection by Purpureocillium lilacinus. Prompt fungal culture, histopathological analysis, and molecular identification are crucial for accurate diagnosis. Antifungal susceptibility testing should be considered for effective treatment.
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Affiliation(s)
- Lijun Zhou
- Department of Dermatology, People’s Hospital of Leshan, Leshan, Sichuan, 614000, People’s Republic of China
| | - Xinyu Qi
- Department of Dermatology, People’s Hospital of Leshan, Leshan, Sichuan, 614000, People’s Republic of China
| | - Guiying Guo
- Department of Dermatology, People’s Hospital of Leshan, Leshan, Sichuan, 614000, People’s Republic of China
| | - Yanling Wang
- Department of Dermatology, People’s Hospital of Leshan, Leshan, Sichuan, 614000, People’s Republic of China
| | - Jianjun Yang
- Department of Dermatology, People’s Hospital of Leshan, Leshan, Sichuan, 614000, People’s Republic of China
| | - Dingbin Yang
- Department of Dermatology, People’s Hospital of Leshan, Leshan, Sichuan, 614000, People’s Republic of China
| | - Shuqiong Huang
- Department of Dermatology, People’s Hospital of Leshan, Leshan, Sichuan, 614000, People’s Republic of China
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Non- Aspergillus Hyaline Molds: A Host-Based Perspective of Emerging Pathogenic Fungi Causing Sinopulmonary Diseases. J Fungi (Basel) 2023; 9:jof9020212. [PMID: 36836326 PMCID: PMC9964096 DOI: 10.3390/jof9020212] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 01/31/2023] [Accepted: 02/01/2023] [Indexed: 02/09/2023] Open
Abstract
The incidence of invasive sino-pulmonary diseases due to non-Aspergillus hyaline molds is increasing due to an enlarging and evolving population of immunosuppressed hosts as well as improvements in the capabilities of molecular-based diagnostics. Herein, we review the following opportunistic pathogens known to cause sinopulmonary disease, the most common manifestation of hyalohyphomycosis: Fusarium spp., Scedosporium spp., Lomentospora prolificans, Scopulariopsis spp., Trichoderma spp., Acremonium spp., Paecilomyces variotii, Purpureocillium lilacinum, Rasamsonia argillacea species complex, Arthrographis kalrae, and Penicillium species. To facilitate an understanding of the epidemiology and clinical features of sino-pulmonary hyalohyphomycoses in the context of host immune impairment, we utilized a host-based approach encompassing the following underlying conditions: neutropenia, hematologic malignancy, hematopoietic and solid organ transplantation, chronic granulomatous disease, acquired immunodeficiency syndrome, cystic fibrosis, and healthy individuals who sustain burns, trauma, or iatrogenic exposures. We further summarize the pre-clinical and clinical data informing antifungal management for each pathogen and consider the role of adjunctive surgery and/or immunomodulatory treatments to optimize patient outcome.
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Complicated multiple organ infection of Purpureocillium lilacinum and varicella-zoster virus infection in a patient with Evans’ syndrome. BLOOD SCIENCE 2022; 4:89-92. [PMID: 35957666 PMCID: PMC9362862 DOI: 10.1097/bs9.0000000000000107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 03/07/2022] [Indexed: 11/26/2022] Open
Abstract
Purpureocillium lilacinum (P lilacinum) is a rare pathogenic fungus, which mainly involves immunocompromised individuals. Here, we report a case of complicated multiple-organ infections involving skin, lungs, and spleen in a 63-year-old female with Evans’ syndrome after 9 months of glucocorticoid treatment. Microbial examinations of skin biopsy and blood samples revealed P lilacinum infections. Posaconazole was effective in this patient. During anti-fungi treatment, she developed varicella-zoster virus infection and was diagnosed through next-generation sequencing examination. In conclusion, P lilacinum may affect different organ systems and is susceptible to posaconazole treatment. The molecular-based methods like microbial cell-free DNA sequencing could provide accurate and timely identification of a wide range of infections.
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Cutaneous dermatomycosis with concurrent Paecilomyces lilacinus and Candida guilliermondii in a patient with longstanding diabetes. JAAD Case Rep 2021; 19:10-13. [PMID: 34901360 PMCID: PMC8639388 DOI: 10.1016/j.jdcr.2021.10.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Accetta J, Powell E, Boh E, Bull L, Kadi A, Luk A. Isavuconazonium for the treatment of Purpureocillium lilacinum infection in a patient with pyoderma gangrenosum. Med Mycol Case Rep 2020; 29:18-21. [PMID: 32547913 PMCID: PMC7286926 DOI: 10.1016/j.mmcr.2020.05.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 05/19/2020] [Accepted: 05/25/2020] [Indexed: 11/25/2022] Open
Abstract
Purpureocillium lilacinum is a rare but emerging pathogen in immunocompromised patients that primarily infects the skin and subcutaneous tissue. We present a novel case of Purpureocillium lilacinum infection in a patient with pyoderma gangrenosum who was successfully treated with isavuconazonium, followed by a literature review of 13 total cases of infection with Purpureocillium lilacinum gathered from a review of the PubMed database. Previous reports have utilized voriconazole, an antifungal with significant toxic side effects. Our case highlights the importance of culture and biopsy in patients with pyoderma gangrenosum who are unresponsive to standard treatment irrespective of pathergy risk.
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Affiliation(s)
- Julia Accetta
- Tulane University, Department of Medicine, 1415 Tulane Avenue, 70112, New Orleans, United States
- Corresponding author.
| | - Emily Powell
- Tulane University, Department of Dermatology, 1415 Tulane Avenue, 70112, New Orleans, United States
| | - Erin Boh
- Tulane University, Department of Dermatology, 1415 Tulane Avenue, 70112, New Orleans, United States
| | - Lisa Bull
- Tulane University, Department of Pathology, 1415 Tulane Avenue, 70112, New Orleans, United States
| | - Abida Kadi
- Tulane University, Department of Pathology, 1415 Tulane Avenue, 70112, New Orleans, United States
| | - Alfred Luk
- Tulane University, Department of Medicine, 1415 Tulane Avenue, 70112, New Orleans, United States
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Nematollahi S, Shoham S. Updates on the Treatment of Non-Aspergillus Hyaline Mold Infections. CURRENT FUNGAL INFECTION REPORTS 2019. [DOI: 10.1007/s12281-019-00364-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Tiwari P, Hazarika N, Ahlawat S, Sen IB, Shirshi N. Paecilomyces as a Cause of Lymph Nodes Enlargement in Hodgkin's Lymphoma. Indian J Pediatr 2017; 84:881-882. [PMID: 28660390 DOI: 10.1007/s12098-017-2411-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Accepted: 06/07/2017] [Indexed: 10/19/2022]
Affiliation(s)
- Priya Tiwari
- Department of Medical and Pediatric Oncology and Hematology, Fortis Memorial Research Institute, Gurgaon, Haryana, 122002, India.
| | - Nandini Hazarika
- Department of Medical and Pediatric Oncology and Hematology, Fortis Memorial Research Institute, Gurgaon, Haryana, 122002, India
| | - Sunita Ahlawat
- Department of Pathology, Fortis Memorial Research Institute, Gurgaon, Haryana, India
| | - Ishita B Sen
- Department of Nuclear Medicine, Fortis Memorial Research Institute, Gurgaon, Haryana, India
| | - Nikhil Shirshi
- Department of Medical and Pediatric Oncology and Hematology, Fortis Memorial Research Institute, Gurgaon, Haryana, 122002, India
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Trinh SA, Angarone MP. Purpureocillium lilacinum tattoo-related skin infection in a kidney transplant recipient. Transpl Infect Dis 2017; 19:10.1111/tid.12689. [PMID: 28273390 PMCID: PMC5547740 DOI: 10.1111/tid.12689] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 11/20/2016] [Accepted: 12/08/2016] [Indexed: 11/29/2022]
Abstract
Purpureocillium lilacinum is an emerging pathogenic mold among immunocompromised hosts that causes cutaneous infections related to skin breakdown. We present the first reported case of P. lilacinum tattoo-related skin infection, to our knowledge. A kidney transplant recipient recently treated for acute cellular rejection presented with skin papules overlying a tattoo. Diagnosis was confirmed on culture, histology, and 18S ribosomal RNA polymerase chain reaction. The morphological features on culture characteristic of P. lilacinum included violet colonies on malt extract agar, long tapering brush-like phialides, and elliptical conidia attached in chains. P. lilacinum has intrinsic resistance to many antifungal agents including amphotericin B, but voriconazole and posaconazole have good in vitro activity. The patient was treated with voriconazole with subsequent resolution of the papules after 3 months of therapy.
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Affiliation(s)
- Sonya A. Trinh
- Division of Infectious Diseases, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States of America
| | - Michael P. Angarone
- Division of Infectious Diseases, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States of America
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Demitsu T, Nagashima K, Okabe T, Morisawa Y, Ishikawa N, Yagisawa T, Fukuta H, Ohtsuki M, Kano R, Harada K. Subcutaneous hyalohyphomycosis due to Purpureocillium lilacinum
in an immunocompromised patient after renal transplantation. J Dermatol 2016; 44:725-726. [DOI: 10.1111/1346-8138.13521] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Toshio Demitsu
- Department of Dermatology; Jichi Medical University Saitama Medical Center; Saitama Japan
| | - Kazutaka Nagashima
- Department of Dermatology; Jichi Medical University Saitama Medical Center; Saitama Japan
| | - Taro Okabe
- Center for Clinical Infectious Diseases; Jichi Medical University Hospital; Shimotsuke Japan
| | - Yuji Morisawa
- Center for Clinical Infectious Diseases; Jichi Medical University Hospital; Shimotsuke Japan
| | - Nobuo Ishikawa
- Department of Urology; Jichi Medical University School of Medicine; Shimotsuke Japan
| | - Takashi Yagisawa
- Department of Urology; Jichi Medical University School of Medicine; Shimotsuke Japan
| | - Hirotaka Fukuta
- Department of Dermatology; Jichi Medical University School of Medicine; Shimotsuke Japan
| | - Mamitaro Ohtsuki
- Department of Dermatology; Jichi Medical University School of Medicine; Shimotsuke Japan
| | - Rui Kano
- Department of Veterinary Pathobiology; Nihon University College of Bioresource Sciences; Fujisawa Japan
| | - Kazutoshi Harada
- Department of Dermatology; Tokyo Medical University School of Medicine; Tokyo Japan
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Mikamo H. Deep-seated mycosis. Med Mycol J 2016; 57:J33-4. [DOI: 10.3314/mmj.57.j33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Hiroshige Mikamo
- Department of Clinical Infection, Aichi Medical University School of Medicine
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Briguglio I, Piras S, Corona P, Gavini E, Nieddu M, Boatto G, Carta A. Benzotriazole: An overview on its versatile biological behavior. Eur J Med Chem 2015; 97:612-48. [PMID: 25293580 PMCID: PMC7115563 DOI: 10.1016/j.ejmech.2014.09.089] [Citation(s) in RCA: 105] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Revised: 09/25/2014] [Accepted: 09/28/2014] [Indexed: 12/13/2022]
Abstract
Discovered in late 1960, azoles are heterocyclic compounds class which constitute the largest group of available antifungal drugs. Particularly, the imidazole ring is the chemical component that confers activity to azoles. Triazoles are obtained by a slight modification of this ring and similar or improved activities as well as less adverse effects are reported for triazole derivatives. Consequently, it is not surprising that benzimidazole/benzotriazole derivatives have been found to be biologically active. Since benzimidazole has been widely investigated, this review is focused on defining the place of benzotriazole derivatives in biomedical research, highlighting their versatile biological properties, the mode of action and Structure Activity Relationship (SAR) studies for a variety of antimicrobial, antiparasitic, and even antitumor, choleretic, cholesterol-lowering agents.
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Affiliation(s)
- I Briguglio
- Department of Chemistry and Pharmacy, University of Sassari, Via Muroni 23/A, 07100 Sassari, Italy
| | - S Piras
- Department of Chemistry and Pharmacy, University of Sassari, Via Muroni 23/A, 07100 Sassari, Italy
| | - P Corona
- Department of Chemistry and Pharmacy, University of Sassari, Via Muroni 23/A, 07100 Sassari, Italy
| | - E Gavini
- Department of Chemistry and Pharmacy, University of Sassari, Via Muroni 23/A, 07100 Sassari, Italy
| | - M Nieddu
- Department of Chemistry and Pharmacy, University of Sassari, Via Muroni 23/A, 07100 Sassari, Italy
| | - G Boatto
- Department of Chemistry and Pharmacy, University of Sassari, Via Muroni 23/A, 07100 Sassari, Italy
| | - A Carta
- Department of Chemistry and Pharmacy, University of Sassari, Via Muroni 23/A, 07100 Sassari, Italy.
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Scientific Opinion on the maintenance of the list of QPS biological agents intentionally added to food and feed (2013 update). EFSA J 2013. [DOI: 10.2903/j.efsa.2013.3449] [Citation(s) in RCA: 90] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
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