Purpureocillium lilacinum as unusual cause of pulmonary infection in immunocompromised hosts

  • Manuel A Salazar-González Department of Internal Medicine. Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León. Monterrey, México
  • Jorge R Violante-Cumpa Department of Internal Medicine. Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León. Monterrey, México
  • Christian G Alfaro-Rivera Department of Infectious Diseases. Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León. Monterrey, Nuevo León, México
  • Hiram Villanueva-Lozano Department of Microbiology. Facultad de Medicina, Universidad Autónoma de Nuevo León. Monterrey, Nuevo León, México
  • Rogelio de Jesús Treviño-Rangel Department of Microbiology. Facultad de Medicina, Universidad Autónoma de Nuevo León. Monterrey, Nuevo León, México
  • Gloria M González Department of Microbiology. Facultad de Medicina, Universidad Autónoma de Nuevo León. Monterrey, Nuevo León, México
Keywords: Purpureocillium lilacinum, Pneumonia, fungal infection, mycology, immunocompromised host, infectious diseases

Abstract

Purpureocillium lilacinum (P. lilacinum) is an emergent pathogenic mold that presents more commonly as an ocular infection, cutaneous and/or subcutaneous infections in patients that are usually immunocompromised. A pulmonary presentation is rare, the clinical presentation is fever and cough with radiographic presentation as pleural effusion, single-lung consolidation, and cavitary pulmonary disease. We present a case of a patient with hematologic malignancy with febrile neutropenia; after receiving chemotherapy, the patient developed a pulmonary infection with multiple bilateral consolidations shown in the thoracic computed tomography scan. Fever persisted in spite of the use of wide-spectrum antibiotics and amphotericin. Bronchoalveolar lavage was performed and the samples were cultured, isolating in the Sabouraud Dextrous Agar a filamentous fungi growth with purple colonies that were identified morphologically as P. lilacinum and later it was confirmed by molecular methods. Once the infectious agent was identified, we continued amphotericin and oral voriconazole was added to the treatment with complete resolution of the infection. The report aims to create awareness of this emerging infectious disease, as there is little information concerning the treatment and the prognosis of patients infected by P. lilacinum with a pulmonary presentation.

Published
2020-04-30
How to Cite
1.
Salazar-González MA, Violante-Cumpa JR, Alfaro-Rivera CG, Villanueva-Lozano H, Treviño-Rangel R de J, González GM (2020) Purpureocillium lilacinum as unusual cause of pulmonary infection in immunocompromised hosts. J Infect Dev Ctries 14:415-419. doi: 10.3855/jidc.12235
Section
Case Reports