Case Report: Cutaneous Mycosis Caused by Purpureocillium lilacinum

Ying Wang Shandong Provincial Hospital for Skin Diseases and Shandong Provincial Institute of Dermatology and Venereology, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China

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Fangfang Bao Shandong Provincial Hospital for Skin Diseases and Shandong Provincial Institute of Dermatology and Venereology, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China

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Xianmei Lu Shandong Provincial Hospital for Skin Diseases and Shandong Provincial Institute of Dermatology and Venereology, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China

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Hong Liu Shandong Provincial Hospital for Skin Diseases and Shandong Provincial Institute of Dermatology and Venereology, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China

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Furen Zhang Shandong Provincial Hospital for Skin Diseases and Shandong Provincial Institute of Dermatology and Venereology, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China

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ABSTRACT.

Purpureocillium lilacinum, widely used as a commercial biocontrol agent for controlling plant-parasitic nematodes, is an emerging opportunistic pathogen in humans and is increasingly reported, especially among immunocompromised patients. We report a classic case of cutaneous mycosis caused by P. lilacinum. A 51-year-old Chinese woman who received tacrolimus and glucocorticoid therapy for 3 years for nephrotic syndrome experienced recurrent papules, pustules, and ulceration on her right ring finger and subcutaneous nodules on her forearm 6 months ago. A lesion biopsy on the right ring finger revealed multiple epithelioid granulomas in the dermis and fat layer containing slender, pigmented fungal hyphae. The fungal culture showed the growth of violet floccose colonies. Lactophenol cotton blue culture stain demonstrated brush-like phialides, with a swollen basal part attached to chains of conidia. Sequencing of the internal transcribed spacer regions of ribosomal DNA, alignment with GenBank, and use of a Basic Local Alignment Search Tool analysis led to the identification of P. lilacinum. Treatment with oral voriconazole was successful.

Author Notes

Address correspondence to Fangfang Bao, Shandong Provincial Hospital for Skin Diseases and Shandong Provincial Institute of Dermatology and Venereology, Shandong First Medical University and Shandong Academy of Medical Sciences, 27397 Jingshi Rd., Jinan, Shandong Province 250022, China. E-mail: baofangfang2008@163.com

Financial support: This study was supported by the National Natural Science Foundation of China (Grant no. 82003369) and the Natural Science Foundation of Shandong Province (Grant no. ZR2019PH069).

Authors’ addresses: Ying Wang, Fangfang Bao, Xianmei Lu, Hong Liu, and Furen Zhang, Shandong Provincial Hospital for Skin Diseases and Shandong Provincial Institute of Dermatology and Venereology, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China, E-mails: 1035747425@qq.com, baofangfang2008@163.com, xinmeilu2013@163.com, hongyue2519@hotmail.com, and zhangfuren@hotmail.com.

  • 1.

    Antas PR , Brito MM , Peixoto É , Ponte CG , Borba CM , 2012. Neglected and emerging fungal infections: review of hyalohyphomycosis by Paecilomyces lilacinus focusing in disease burden, in vitro antifungal susceptibility and management. Microbes Infect 14: 18.

    • Search Google Scholar
    • Export Citation
  • 2.

    Kam S , Hicks AB , Allos BM , Boyd AS , 2021. Cutaneous dermatomycosis with concurrent Paecilomyces lilacinus and Candida guilliermondii in a patient with longstanding diabetes. JAAD Case Rep 19: 1013.

    • Search Google Scholar
    • Export Citation
  • 3.

    Guo LN , Wang H , Hsueh PR , Meis JF , Chen H , Xu YC , 2019. Endophthalmitis caused by Purpureocillium lilacinum. J Microbiol Immunol Infect 52: 170171.

    • Search Google Scholar
    • Export Citation
  • 4.

    Rimawi RH , Carter Y , Ware T , Christie J , Siraj D , 2013. Use of voriconazole for the treatment of Paecilomyces lilacinus cutaneous infections: case presentation and review of published literature. Mycopathologia 175: 345349.

    • Search Google Scholar
    • Export Citation
  • 5.

    Carolus H , Pierson S , Lagrou K , Van Dijck P , 2020. Amphotericin B, and other polyenes–discovery, clinical use, mode of action and drug resistance. J Fungi (Basel) 6: 321.

    • Search Google Scholar
    • Export Citation
  • 6.

    Monpierre L et al., 2022. Species identification and in vitro antifungal susceptibility of Paecilomyces/Purpureocillium species isolated from clinical respiratory samples: a multicenter study. J Fungi (Basel) 8: 684.

    • Search Google Scholar
    • Export Citation
  • 7.

    Sprute R et al., 2021. Invasive infections with Purpureocillium lilacinum: clinical characteristics and outcome of 101 cases from FungiScope® and the literature. J Antimicrob Chemother 76: 15931603.

    • Search Google Scholar
    • Export Citation
  • 8.

    Sprute R , 2021. Characterization and outcome of invasive infections due to Paecilomyces variation: analysis of patients from the FungiScope® registry and literature reports. J Antimicrob Chemother 76: 765774.

    • Search Google Scholar
    • Export Citation
  • 9.

    Wu PC , Lai CH , Tan HY , Ma DH , Hsiao CH , 2010. The successful medical treatment of a case of Paecilomyces lilacinus keratitis. Cornea 29: 357358.

    • Search Google Scholar
    • Export Citation
  • 10.

    Garzoni C , Garbino J , 2008. New azoles as first-line therapy for Paecilomyces lilacinus in transplant patients. Transpl Infect Dis 10: 149150.

    • Search Google Scholar
    • Export Citation
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