Therapeutic Use of Posaconazole for Cutaneous Purpureocillium lilacinum Infection Refractory to Itraconazole

Q4 Medicine Journal of Mycology and Infection Pub Date : 2023-09-30 DOI:10.17966/jmi.2023.28.3.79

Jin Ho Kim, Y. Bang, Jae Bok Jun, Weon Ju Lee

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Abstract

Purpureocillium lilacinum is a saprophytic fungus with a ubiquitous environmental distribution. Unfortunately, no standard treatment has yet been established for cutaneous P. lilacinum infections. Based on the in vitro antifungal susceptibility test, posaconazole has been considered an effective treatment option. We herein present a case involving a 72-year-old woman who visited our clinic due to a peripherally spreading, well-demarcated, asymptomatic, scaly, and erythematous patch on her forehead that had persisted for 4 months. She had been diagnosed with cutaneous P. lilacinum infection and had been treated with itraconazole (200 mg/day). However, the lesion recurred in the same area. Histopathological findings revealed suppurative granulomatous dermatitis with fungal elements. Fungal culture confirmed P. lilacinum regrowth. Posaconazole was selected to treat the recurrence of P. lilacinum infection. After 10 weeks of treatment, the lesion decreased dramatically without any adverse drug events. We recommend posaconazole as a treatment option for P. lilacinum infection refractory to itraconazole.

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泊沙康唑治疗伊曲康唑难治的皮肤紫癜疫霉菌感染

紫丁香疫霉菌是一种溶菌性真菌，在环境中的分布无处不在。遗憾的是，目前还没有针对皮肤紫癣菌感染的标准治疗方法。根据体外抗真菌药敏试验，泊沙康唑被认为是一种有效的治疗方法。我们在此介绍一例病例，患者是一名 72 岁的妇女，因前额出现周缘扩散、分界清楚、无症状、鳞屑和红斑，且已持续 4 个月而就诊。她曾被诊断为皮肤紫丁香癣菌感染，并接受了伊曲康唑（200 毫克/天）治疗。然而，皮损在同一部位复发。组织病理学检查结果显示，化脓性肉芽肿性皮炎伴有真菌成分。真菌培养证实了丝核菌的重新生长。患者选择了泊沙康唑来治疗丝核菌感染的复发。治疗 10 周后，皮损明显减轻，且未出现任何药物不良反应。我们建议将泊沙康唑作为伊曲康唑难治性丝状癣菌感染的治疗选择。

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Journal of Mycology and Infection Medicine-Infectious Diseases

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0.20

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0.00%

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期刊介绍： The Journal of mycology and infection (Acronym: JMI, Abbreviation: J Mycol Infect) aims to publish articles of exceptional interests in the field of medical mycology. The journal originally was launched in 1996 as the Korean Journal of Medical Mycology and has reformed into the current state beginning on March of 2018. The contents of the journal should elucidate important microbiological fundamentals and provide qualitative insights to respective clinical aspects. JMI underlines the submission of novel findings and studies in clinical mycology that are enriched by analyses achieved through investigative methods. The journal should be of general interests to the scientific communities at large and should provide medical societies with advanced breadth and depth of mycological expertise. In addition, the journal supplements infectious diseases in adjunct to the field of mycology to address a well-rounded understanding of infectious disorders. The Journal of mycology and infection, which is issued quarterly, in March, June, September and December each year, published in English. The scope of the Journal of mycology and infection includes invited reviews, original articles, case reports, letter to the editor, and images in mycology. The journal is compliant to peer-review/open access and all articles undergo rigorous reviewing processes by our internationally acknowledged team of editorial boards. The articles directed to publication should encompass in-depth materials that employ scholastic values of mycology and various infectious diseases. Articles responding to critical methodology and outcomes which have potential to enhance better understanding of mycology and infectious diseases are also suitable for publication.