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Case Reports
. 2021 Aug 18;10(8):1046.
doi: 10.3390/pathogens10081046.

First Report of a Case of Ocular Infection Caused by Purpureocillium lilacinum in Poland

Robert Kuthan  1 , Anna K Kurowska  2   3 , Justyna Izdebska  2   3 , Jacek P Szaflik  2   3 , Anna Lutyńska  4 , Ewa Swoboda-Kopeć  4
Affiliations
Case Reports

First Report of a Case of Ocular Infection Caused by Purpureocillium lilacinum in Poland

Robert Kuthan et al. Pathogens. .

Abstract

This report describes the first case of an ocular infection induced by Purpureocillium lilacinum in Poland. The patient was a 51-year-old immunocompetent contact lens user who suffered from subacute keratitis and progressive granulomatous uveitis. He underwent penetrating keratoplasty for corneal perforation, followed by cataract surgery due to rapid uveitic cataract. A few weeks later, intraocular lens removal and pars plana vitrectomy were necessary due to endophthalmitis. The patient was treated with topical, systemic, and intravitreal voriconazole with improvement; however, the visual outcome was poor. The pathogen was identified by MALDI-TOF MS.

Keywords: Paecilomyces lilacinus; Poland; Purpureocillium lilacinum; keratitis; voriconazole.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
The Vitek MS® MALDI-TOF MS spectrum characteristic for P. lilacinum.
Figure 2
Figure 2
The slit lamp examination of the left eye: mild lid edema, moderate mixed conjunctival injection and chemosis, and central keratitis.
Figure 3
Figure 3
Fungal keratitis: deep stromal infiltrate with feathery edges.
Figure 4
Figure 4
In vivo confocal microscopy: linear structures with a dichotomous branching pattern of fungal hyphae in the corneal stroma.
Figure 5
Figure 5
Central corneal perforation.
Figure 6
Figure 6
Iris nodules at 11.00 and 12.00 o’clock and fibrinous vascularized membrane adherent to the iris and anterior lens capsule.
Figure 7
Figure 7
Mature cataract and inflammatory fibrous membrane in the pupil.
Figure 8
Figure 8
Microscopic appearance of P. lilacinum isolated from the liquid Sabouraud culture. Magnification × 1000.
Figure 9
Figure 9
Microscopic appearance of P. lilacinum isolated from culture on Sabouraud agar. Magnification × 1000.
Figure 10
Figure 10
Microscopic appearance of P. lilacinum isolated from culture on Sabouraud agar. Magnification × 1000.
Figure 11
Figure 11
Growth of P. lilacinum on Sabouraud agar.
Figure 12
Figure 12
Inflammatory cells and protein exudate in the anterior chamber.
Figure 13
Figure 13
The inflammatory fibrinous membrane on the artificial lens.
See this image and copyright information in PMC

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