Isavuconazonium for the treatment of Purpureocillium lilacinum infection in a patient with pyoderma gangrenosum

Successful treatment of Purpureocillium lilacinum pulmonary infection with isavuconazole: A case report

“…Moreover, compared with posaconazole, isavuconazole has a cost-effective option for treating invasive mold diseases in high-risk hematological patients[ 16 ]. We could identify only one case of a cutaneous infection caused by P. lilacinum used to treat a patient who was successfully cured by PubMed[ 17 ]. Huang et al [ 18 ] conducted a pharmacokinetic study of intravenous isavuconazole in healthy subjects, finding that lung tissue/plasma concentration was 1.438[ 18 ].…”

Chronic subcutaneous infection of Purpureocillium lilacinum in an immunocompromised patient: Case report and review of the literature

“…Echinocandins show variable MICs. Based on the literature at the date of our case, treatment is not consensual, but some cases reported clinical success of voriconazole [ 6 , 12 , 13 ] and in two sporadic cases with posaconazole [ 13 , 14 ], including one after failure with voriconazole. A study [ 15 ] suggested that association of voriconazole and terbinafine has a synergistic interaction in in vitro culture, but it is still of debate.…”

Cutaneous Hyalohyphomycosis and Its Atypical Clinical Presentations in Immunosuppressed Patients

“…A definitive diagnosis of hyalohyphomycosis requires the isolation of the fungal organism, in the form of a positive fungal culture [6,8]. The exact identification of the fungus is paramount due to the often-high intrinsic resistance of many of the fungi in this group to most widely used antifungal agents (see Table 1) [9,10]. Hyalohyphomycosis is an emerging infection among immunosuppressed individuals, ranging from cutaneous forms to severe systemic and disseminated infections.…”

“…Almost all of the fungi from this group are widely distributed in the environment and can enter the human body via inhalation or inoculation in a site of skin or mucosal breakdown [11][12][13]. Altogether, skin is the most frequently affected organ, either as the site of primary infection or as affected tissue in the disseminated disease, with variable clinical presentations [9,[14][15][16]. Cutaneous hyalohyphomycosis ranges from superficial skin infections, including onychomycosis, to deep cutaneous and subcutaneous infections.…”

“…Due to the ubiquitous distribution of P. lilacinum in the environment, there are multiple possible modes of infection [41]. The most frequent infection sites are the skin, subcutaneous tissue, and eyes, although it can spread through the bloodstream, causing infections in various organs, such as the lungs, sinuses, and CNS [9]. Infection commonly occurs via the inhalation of the fungus and its consequent dissemination to the skin and other sites or directly, through inoculation at a site of skin or mucosal breakdown [11].…”