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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.
Abstract:
Paecilomyces species are a rare cause of fungal pulmonary infections in immunocompromised hosts. Paecilomyces variotii and Paecilomyces lilacinus are the two most common species of clinical significance. Both species differ in their susceptibility to antifungal agents. We present a rare case of a 47-year-old immunocompromised woman who developed Paecilomyces pneumonia despite being on voriconazole prophylaxis. We also present a review of the literature on other reported cases.
Learning Points:
Paecilomyces species differ in their susceptibility to antifungal agents.Breakthrough invasive mould infections are increasingly being documented in immunocompromised patients on voriconazole prophylaxis.Posaconazole has been shown to be effective against both Paecilomyces species.
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.
