Paecilomyces in an immune competent host

Paecilomyces/Purpureocillium Infection in Children, Case Report, and Review of the Literature

Paecilomyces/Purpureocillium has recently been recognized as an emerging human pathogen, causing serious infection in immunocompromised and immunocompetent patients. Several predisposing factors have been reported, including foreign body implants, previous surgery, or trauma. Treatment with antifungal drugs often fails as species-specific differences in antifungal susceptibilities are one of the management challenges. Surgical debridement with or without antifungal therapy was sufficient to cure the infection in a few reported cases. Nonetheless, the surgical approach has been found to decrease the chance of dissemination and recurrence. Here, we report the first pediatric patient with chronic osteomyelitis of the femur secondary to Paecilomyces species, with no predisposing risk factors. Our case was successfully treated with a combination of antifungal therapy and surgical debridement. Additionally, we describe the first extensive literature review of previously reported Paecilomyces/Purpureocillium species infections in pediatric age groups.

Allicin as a Volatile or Nebulisable Antimycotic for the Treatment of Pulmonary Mycoses: In Vitro Studies Using a Lung Flow Test Rig

Fungal infections of the lung are an increasing problem worldwide and the search for novel therapeutic agents is a current challenge due to emerging resistance to current antimycotics. The volatile defence substance allicin is formed naturally by freshly injured garlic plants and exhibits broad antimicrobial potency. Chemically synthesised allicin was active against selected fungi upon direct contact and via the gas phase at comparable concentrations to the pharmaceutically used antimycotic amphotericin B. We investigated the suppression of fungal growth by allicin vapour and aerosols in vitro in a test rig at air flow conditions mimicking the human lung. The effect of allicin via the gas phase was enhanced by ethanol. Our results suggest that allicin is a potential candidate for development for use in antifungal therapy for lung and upper respiratory tract infections.

Case Report: Novel Disseminated Paecilomyces formosus Infection in a Dog

A 2.5-year-old, 25.5 kg, spayed female Australian Shepherd dog had a 2-month history of shifting leg lameness in all limbs, tetraparesis, progressive lethargy, and severe pain. On the physical examination, fever (40.61°C), tachycardia, tachypnea, mild diffuse pelvic limb muscular atrophy, left prescapular and right popliteal lymphadenomegaly were observed. Due to the poor prognosis and difficult pain management, humane euthanasia was elected. Macroscopic and histological findings revealed multifocal to coalescing granulomas with central areas of lytic necrosis within the right femur, left humerus, left scapula, left biceps brachii, right semimembranosus muscle, liver, spleen, and lymph nodes. The necrotic areas contained myriad intralesional, intracellular, and extracellular negatively stained, non-pigmented, septate acute angle branching hyphae with parallel walls measuring 3–6 μm in width with polar bulbous projections measuring 7–13 μm in width. Fresh samples of the liver were submitted for fungal culture. Panfungal PCR targeting the major conserved genes-ITS, TUB, CAL-confirmed Paecilomyces formosus. Paecilomyces spp. are members of anamorphic fungi classified under the phylum Ascomycota. Paecilomycosis is an uncommon fungal infection caused by Paecilomyces spp with a disease reported in humans and animals ranging from superficial to systemic clinical forms affecting both immunocompromised and immunocompetent individuals. In dogs, disseminated paecilomycosis has been reported, but the species of fungi are not always determined. To our knowledge, this is the first case of disseminated paecilomycosis caused by P. formosus infection in a dog.