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Yang XL, Zhang JY, Ren JM. Successful treatment of Purpureocillium lilacinum pulmonary infection with isavuconazole: A case report. World J Clin Cases 2024; 12:1772-1777. [PMID: 38660073 PMCID: PMC11036475 DOI: 10.12998/wjcc.v12.i10.1772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 02/05/2024] [Accepted: 03/18/2024] [Indexed: 04/02/2024] Open
Abstract
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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Affiliation(s)
- Xue-Lin Yang
- Department of Emergency Medicine, Lishui Central Hospital, Lishui 323000, Zhejiang Province, China
| | - Jun-Yu Zhang
- Department of Hematology, Lishui Central Hospital, Lishui 323000, Zhejiang Province, China
| | - Jian-Min Ren
- Department of Clinical Laboratory, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui 323000, Zhejiang Province, China
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Ferara N, Špoljar S, Lugović-Mihić L, Gverić Grginić A, Rezo Vranješ V, Bešlić I, Perović J, Regović Džombeta T. Cutaneous Hyalohyphomycosis and Its Atypical Clinical Presentations in Immunosuppressed Patients. Life (Basel) 2024; 14:154. [PMID: 38276283 PMCID: PMC10817673 DOI: 10.3390/life14010154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 01/06/2024] [Accepted: 01/17/2024] [Indexed: 01/27/2024] Open
Abstract
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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Affiliation(s)
- Nikola Ferara
- Department of Dermatovenereology, Sestre Milosrdnice University Hospital Centre, 10000 Zagreb, Croatia; (N.F.); (S.Š.); (I.B.); (J.P.)
- Department of Biology, Faculty of Science, University of Zagreb, 10000 Zagreb, Croatia
| | - Sanja Špoljar
- Department of Dermatovenereology, Sestre Milosrdnice University Hospital Centre, 10000 Zagreb, Croatia; (N.F.); (S.Š.); (I.B.); (J.P.)
| | - Liborija Lugović-Mihić
- Department of Dermatovenereology, Sestre Milosrdnice University Hospital Centre, 10000 Zagreb, Croatia; (N.F.); (S.Š.); (I.B.); (J.P.)
- School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Ana Gverić Grginić
- Department of Microbiology, Parasitology and Hospital Infections, Sestre Milosrdnice University Hospital Centre, 10000 Zagreb, Croatia;
| | - Violeta Rezo Vranješ
- Department of Clinical and Molecular Microbiology, University Hospital Centre Zagreb, 10000 Zagreb, Croatia;
| | - Iva Bešlić
- Department of Dermatovenereology, Sestre Milosrdnice University Hospital Centre, 10000 Zagreb, Croatia; (N.F.); (S.Š.); (I.B.); (J.P.)
- School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Judita Perović
- Department of Dermatovenereology, Sestre Milosrdnice University Hospital Centre, 10000 Zagreb, Croatia; (N.F.); (S.Š.); (I.B.); (J.P.)
| | - Tihana Regović Džombeta
- Clinical Department of Pathology and Cytology, Sestre Milosrdnice University Hospital Center, 10000 Zagreb, Croatia;
- Department of Pathology, University of Zagreb School of Medicine, 10000 Zagreb, Croatia
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Majima H, Inoue Y, Otsuka Y, Yaguchi T, Watanabe A, Kamei K. Lymphadenitis caused by Purpureocillium lilacinum in a patient with CARD9 deficiency. Med Mycol Case Rep 2023; 42:100609. [PMID: 37767185 PMCID: PMC10520493 DOI: 10.1016/j.mmcr.2023.100609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 09/03/2023] [Accepted: 09/12/2023] [Indexed: 09/29/2023] Open
Abstract
We hereby make the first report of a case of mycosis caused by Purpureocillium lilacinum in CARD9 deficiency. A 40-year-old woman complained of lymph node swellings in the left cervical area. She also had chronic mucocutaneous candidiasis (CMC), and was found to have CARD9 deficiency. Lymphadenitis by P. lilacinum was confirmed. The diagnosis was difficult, as culturing the biopsy specimen at a cautiously selected temperature (25 °C) and genetic analysis were both required. Oral administration of voriconazole improved her lymphadenopathy.
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Affiliation(s)
- Hidetaka Majima
- Division of Clinical Research, Medical Mycology Research Center, Chiba University, Chiba, Japan
| | - Yuzaburo Inoue
- Department of General Medical Science, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yuichiro Otsuka
- Division of Otolaryngology, Chiba Kaihin Municipal Hospital, Chiba, Japan
| | - Takashi Yaguchi
- Management of Unit of Microbiological Resources, Medical Mycology Research Center, Chiba University, Chiba, Japan
| | - Akira Watanabe
- Division of Clinical Research, Medical Mycology Research Center, Chiba University, Chiba, Japan
| | - Katsuhiko Kamei
- Department of Infectious Disease, Japanese Red Cross Ishinomaki Hospital, Miyagi, Japan
- Division of Infection Control and Prevention, Medical Mycology Research Center, Chiba University, Chiba, Japan
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