Purpureocillium lilacinum: A minireview

Abstract

Purpureocillium lilacinum (formerly Paecilomyces lilacinus) is a hyaline hyphomycete with a ubiquitous distribution. In the last decade this fungus has been increasingly found as the causal agent of infections in humans and other vertebrates. It is an emerging opportunistic pathogen and is increasingly reported, and can cause a wide spectrum of clinical manifestations, especially among immunocompromised patients or following surgical procedures. The pathogenic mechanisms are not yet fully understood. Ocular and cutaneous/subcutaneous infections are the most familiar clinical presentations, and these can also cause disseminated infections. Early and accurate species identification and susceptibility testing are vital. In general, surgical debridement combined with antifungal drug therapy, or the correction of predisposing factors, are usually required to obtain improvement. Infections present a therapeutic challenge, as they have intrinsic resistance to many antifungal agents, but voriconazole and posaconazole are good in vitro activity. The overall mortality was 22% and death was attributed to the infection in 46% of cases. Accurate diagnoses can be achieved through newer molecular biological techniques, and these can lead to appropriate management of infections due to this organism. Future studies should ideally aim to elucidate pathogenesis and determine more effective diagnoses and effective antifungal treatment.

Keywords: Hyalohyphomycosis; Identification; Immunocompromised status; Minireview; Purpureocillium lilacinum; Treatment.