Paecilomyces javanicus <i>Endocarditis of Native and Prosthetic Aortic Valve</i>

Allevato, Pat A.; Ohorodnik, Julius M.; Mezger, Eugene; Eisses, John F.

doi:10.1093/ajcp/82.2.247

Cited by 18 publications

(7 citation statements)

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“…Other species occasionally associated with humans infections are P. marquandii [5,6] and P. javanicus. [7] P. lilacinus can cause many diseases in humans especially in immunocompromised patients. Cutaneous infections are the second most common type of Paecilomyces-related infection.…”

Section: Introductionmentioning

confidence: 99%

Cutaneous Paecilomyces lilacinus infections in immunocompromised and immunocompetent patients

Bassiri-Jahromi¹

2014

Indian J Dermatol Venereol Leprol

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Paecilomyces is a genus of saprophytic fungus that has been associated, in rare instances, with human disease. We report two cases in which Paecilomyces lilacinus was isolated from cutaneous and subcutaneous lesions in an immunocompromised and an immunocompetent host. The first case was a subcutaneous infection due to P. lilacinus in a patient with a renal transplant and diabetes mellitus. The second case was an immunocompetent young woman who developed a cutaneous infection, with no identified predisposing factors. A biopsy from each patient provided an initial diagnosis of fungal elements in the tissues under examination and multiple positive fungal cultures were obtained from the tissue biopsy samples. Both microscopic and macroscopic examinations of the biopsy revealed the presence of P. lilacinus. Each of the two cases was successfully treated with oral ketoconazole (200 mg/day) and itraconazole. We also review previously reported cases in which the clinical history and response to therapy were noted.

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Section: Introductionmentioning

confidence: 99%

Cutaneous Paecilomyces lilacinus infections in immunocompromised and immunocompetent patients

Bassiri-Jahromi¹

2014

Indian J Dermatol Venereol Leprol

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“…There were no previous data about the in vitro susceptibility of P. javanicus, even though this species has been responsible for two cases of endocarditis (2,17). Our study included four strains of P. javanicus, for which the MICs of amphotericin B, miconazole, itraconazole, and ketoconazole were low.…”

Section: Discussionmentioning

confidence: 99%

“…Endocarditis is among the most severe infections caused by Paecilomyces spp., and the mortality rate among patients with Paecilomyces endocarditis is high. In total seven cases of en-docarditis have been reported, five of which (15,20,23,40,42) were caused by P. variotii and two of which (2,17) were caused by P. javanicus. All seven patients died, and they had all been treated with amphotericin B.…”

Section: Discussionmentioning

confidence: 99%

Antifungal Susceptibilities ofPaecilomycesSpecies

Aguilar¹,

Pujol

Sala

et al. 1998

Antimicrob Agents Chemother

102

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The MICs and minimum fungicidal concentrations (MFCs) of amphotericin B, miconazole, itraconazole, ketoconazole, fluconazole, and flucytosine for 52 isolates of Paecilomyces species were evaluated by the broth microdilution method, largely based on the recommendations of the National Committee for Clinical Laboratory Standards (document M27-A). The fungal isolates tested included 16P. variotii, 11 P. lilacinus, 9 P. marquandii, 6 P. fumosoroseus, 4 P. javanicus, and 2 P. viridis isolates and 1 isolate of each of the following species: P. carneus, P. farinosus, P. fulvus, and P. niveus. The MFCs and the MICs at which 90% of isolates were inhibited (MIC90s) for the six antifungal agents were remarkably high; the MIC50s indicated that amphotericin B, miconazole, itraconazole, and ketoconazole had good activities, while fluconazole and flucytosine demonstrated poor efficacy. The ranges of the MICs were generally wider and lower than those of the MFCs. There were significant susceptibility differences among the species. All species with the exception of P. variotii were highly resistant to fluconazole and flucytosine; P. variotii was susceptible to flucytosine. Amphotericin B and the rest of the azoles showed good activity against P. variotii, while all the antifungal agents assayed showed low efficacy against P. lilacinus.

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“…Paecilomyces lilacinus and Paecilomyces variotii are the two species associated most frequently with human disease. Other species reported to infect humans occasionally are Paecilomyces marquandii [6,7] and Paecilomyces javanicus [8]. This article reviews cases of P. lilacinus infection reported between 1964 and 2004, and summarises the available data concerning the main clinical manifestations, predisposing factors, treatments and outcome.…”

Section: Introductionmentioning

confidence: 99%

Clinical manifestations, treatment and outcome of Paecilomyces lilacinus infections

Pastor

Guarro

2006

Clinical Microbiology and Infection

196

228

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The fungus Paecilomyces lilacinus is an emerging pathogen that causes severe human infections, including devastating oculomycosis. Usually, it shows low susceptibility to conventional antifungal drugs in vitro, and variable susceptibility to novel triazoles. A review of the published literature identified 119 reported cases of human infection by P. lilacinus between 1964 and 2004. Most were cases of oculomycosis (51.3%), followed by cutaneous and sub-cutaneous infections (35.3%), and a smaller group of miscellaneous infections (13.4%). Lens implantation is the most frequent predisposing factor for oculomycosis. Cutaneous and sub-cutaneous infections occur mainly in solid organ and bone marrow transplant recipients, although surgery and primary or acquired immunodeficiency are also relevant predisposing factors. Infections in apparently immunocompetent patients have also been reported. Surgical debridement combined with antifungal drug therapy, or the correction of predisposing factors, such as neutropenia, are usually required to obtain improvement. Treatment with traditional antifungal drugs often fails. Voriconazole has demonstrated good activity in both cutaneous and ocular infections in the few cases in which this drug has been used. The new triazoles ravuconazole and posaconazole show good in-vitro activity against P. lilacinus and could be promising therapeutic alternatives.

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Paecilomyces javanicus Endocarditis of Native and Prosthetic Aortic Valve

Cited by 18 publications

References 0 publications

Cutaneous Paecilomyces lilacinus infections in immunocompromised and immunocompetent patients

Cutaneous Paecilomyces lilacinus infections in immunocompromised and immunocompetent patients

Antifungal Susceptibilities ofPaecilomycesSpecies

Clinical manifestations, treatment and outcome of Paecilomyces lilacinus infections

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