Hyalohyphomycosis caused by Paecilomyces variotii in an obstetrical patient

Athar, M.A.; Sekhon, Awatar S.; McGrath, Joanna; Malone, R

doi:10.1007/bf00144425

Cited by 14 publications

(8 citation statements)

References 11 publications

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“…2,[4][5][6][7][8][9][10][11] Paecilomyces variotii pneumonia, endophthalmitis, sinusitis, peritonitis and soft tissue infections have also been reported in otherwise healthy patients. 3,[12][13][14][15][16][17][18][19] Paecilomyces lilacinus is commonly associated with ocular lens implant infections and invasive soft tissue infections, both of which have been seen in immunocompromised and immunocompetent patients. 20 Unfortunately, symptoms of infection appear to be non-specific and may be difficult to distinguish from other fungal infections.…”

Section: Literature Review and Discussionmentioning

confidence: 99%

Treatment of Paecilomyces variotii pneumonia with posaconazole: case report and literature review

Feldman

Cockerham

Buchan

et al. 2016

Mycoses

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The fungi Paecilomyces variotii is a potential pathogen in immunocompromised and immunocompetent patients. Their rare association with clinical disease results in scarce literature regarding susceptibility and treatment. Here, we discuss a case involving successful treatment of probable P. variotii pneumonia with posaconazole after treatment failure with voriconazole. The current literature related to antifungal susceptibility profiles, microbiological identification methods and clinical management of infections caused by this organism is also reviewed.

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Section: Literature Review and Discussionmentioning

confidence: 99%

Treatment of Paecilomyces variotii pneumonia with posaconazole: case report and literature review

Feldman

Cockerham

Buchan

et al. 2016

Mycoses

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“…Immunosuppression is the critical risk factor for infection; and cases of pneumonia (7), sinusitis (13,34,50), endophthalmitis (25,49), otitis media (12), wound infection in a transplant recipient (26), cutaneous hyalohyphomycoses (3,29), onychomycosis (2), osteomyelitis in a patient with granulomatous disorder (10), and dialysis-related peritonitis (38) have all been reported to be caused by this fungus. This species can be considered extremotolerant and is able to grow at high temperatures, on decaying wood, and on creosote treated wooden utility poles (E. de Meyere et al, unpublished data).…”

Section: Discussionmentioning

confidence: 99%

Identification ofPaecilomyces variotiiin Clinical Samples and Settings

et al. 2010

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Paecilomyces variotii is a commonly occurring species in air and food, but it is also associated with many types of human infections and is among the emerging causative agents of opportunistic mycoses in immunocompromised hosts. Paecilomyces can cause hyalohyphomycosis, and two species, Paecilomyces lilacinus and P. variotii, are the most frequently encountered organisms. In the present study, a set of 34 clinical isolates morphologically identified as P. variotii or P. lilacinus were formally identified by sequencing intergenic transcribed spacer regions 1 and 2 (including 5.8S rDNA) and a part of the ␤-tubulin gene. Three isolates were identified as P. lilacinus, and five of the presumptive P. variotii isolates did not belong to the genus Paecilomyces but were identified as Talaromyces eburneus (anamorph, Geosmithia argillacea) or Hamigera avellanea (anamorph, Merimbla ingelheimense). Applying the most recent taxonomy, we found that the clinical P. variotii isolates could be identified as P. variotii sensu stricto (14 strains), P. formosus (11 strains), and P. dactylethromorphus (1 strain). These data indicate that P. formosus occurs in clinical samples as commonly as P. variotii. Susceptibility tests showed that the antifungal susceptibility profiles of P. variotii, P. formosus, and P. dactylethromorphus are similar and that all strains tested were susceptible to amphotericin B in vitro. P. lilanicus, T. eburneus, and H. avellanea had different susceptibility profiles; and flucytosine and voriconazole were the least active of the antifungal drugs tested against these species. Our results indicate that correct species identification is important to help guide appropriate antifungal therapy.Paecilomyces variotii is a commonly occurring species that has previously been isolated from various substrates, including (pasteurized) foods, soil, indoor air, and wood (23,36,41,42,43). However, it is also associated with many types of human infections and is listed among the emerging causative agents of opportunistic mycoses in immunocompromised hosts. Paecilomyces can cause hyalohyphomycosis (1), and two species, Paecilomyces lilacinus and P. variotii, are the most frequently encountered (20, 52). Both species are morphologically similar but can be differentiated on the basis of conidial color and growth rates (41). However, small-subunit ribosomal gene sequences showed that the two species are unrelated: P. variotii belongs to the order Eurotiales, while P. lilacinus is a member of the order Hypocreales (27). Although they are uncommon, Paecilomyces infections are associated with almost any organ or system of the human body (40). Most cases concern immunocompromised patients and are cutaneous or catheter related. However, dissemination, for example, that involving the central nervous system, has been observed in a number of cases (15,24). Ocular infections associated with prolonged contact lens use or ocular surgery have also been reported (40), as has peritonitis in patients with continuous ambulatory peritoneal dialy...

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“…Genus Penicillium, occupying a large share of soil mycobiota, can be the etiologic agent of respiratory, gastrointestinal, and skin infections [24,25]. Paecilomyces variotii and P. liliacinus were isolated from patients with inflammation of the vagina or after caesarean section [26,27]. The literature describes cases of CNS or pulmonary aspergillosis, mostly related to infection caused by A. flavus and A. fumigatus, but also increasingly A. terreus [28,29].…”

Section: Discussionmentioning

confidence: 99%