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Paecilomyces Pneumonia Despite Voriconazole Prophylaxis: A Case Report and Literature Review

Abuzar A Asif1, Moni Roy1, Sharjeel Ahmad2

  • 1Department of Internal Medicine, University of Illinois College of Medicine at Peoria, OSF Saint Francis Medical Center, Peoria, USA.

European Journal of Case Reports in Internal Medicine
|July 16, 2021
PubMed

Insights

Paecilomyces pneumonia is a rare fungal infection in immunocompromised individuals. Breakthrough infections can occur even with voriconazole prophylaxis, but posaconazole shows effectiveness against these Paecilomyces species.

Area of Science:

  • Mycology
  • Infectious Diseases
  • Pulmonology

Background:

  • Paecilomyces species are uncommon causes of fungal pulmonary infections, primarily affecting immunocompromised hosts.
  • Paecilomyces variotii and Paecilomyces lilacinus are the most clinically relevant species, exhibiting differential susceptibility to antifungal medications.

Purpose of the Study:

  • To report a rare case of Paecilomyces pneumonia in an immunocompromised patient receiving voriconazole prophylaxis.
  • To review existing literature on Paecilomyces pulmonary infections in immunocompromised individuals.

Main Methods:

  • Case report of a 47-year-old immunocompromised woman with Paecilomyces pneumonia.
  • Literature review of previously reported cases of Paecilomyces pulmonary infections.

Main Results:

  • The patient developed Paecilomyces pneumonia despite prophylactic voriconazole treatment, highlighting breakthrough infections.
  • Literature review indicates varying antifungal susceptibility profiles among Paecilomyces species.

Conclusions:

  • Paecilomyces species demonstrate distinct antifungal susceptibility patterns.
  • Invasive mold infections by Paecilomyces are increasingly observed in immunocompromised patients on voriconazole prophylaxis.
  • Posaconazole has demonstrated efficacy against both Paecilomyces variotii and Paecilomyces lilacinus.
Keywords:
Paecilomycespneumoniaposaconazoleresistancevoriconazole

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