Korean J Med Mycol.  2019 Jun;24(2):52-57. 10.17966/JMI.2019.24.2.52.

A Case of Deep Cutaneous Purpureocillium lilacinum Fungal Infection in an Immunocompetent Patient

Affiliations
  • 1Department of Dermatology, Busan Paik Hospital, College of Medicine, Inje University, Busan, Korea. derma09@hanmail.net
  • 2Department of Laboratory Medicine and Paik Institute for Clinical Research, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea.

Abstract

Purpureocillium is a genus of saprophytic fungi that is commonly found in soil or rotting material. Although rarely a pathogen in humans, it can cause serious infections in immunocompromized patients. An 85-year-old woman presented with a 2-week history of pruritic erythematous plaques with yellowish crusts on her right forearm and dorsal hand. Histopathological analysis identified fungal hyphae and spores in the dermis, and Purpureocillium lilacinum was identified through tissue culture, polymerase chain reaction, and DNA sequencing. The skin lesion barely responded to 4 weeks of itraconazole treatment but improved upon the addition of terbinafine. The skin lesion was completely cured after 12 weeks, with no recurrence to date. Here, we report a rare deep cutaneous fungal infection caused by P. lilacinum in an immunocompetent patient and postulate that, in this case, the patient's agricultural lifestyle increased the possibility of P. lilacinum infection.

Keyword

Deep fungal infection; Immunocompetent host; Purpureocillium lilacinum

MeSH Terms

Aged, 80 and over
Dermis
Female
Forearm
Fungi
Hand
Humans
Hyphae
Itraconazole
Life Style
Polymerase Chain Reaction
Recurrence
Sequence Analysis, DNA
Skin
Soil
Spores
Itraconazole
Soil
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