Purpureocillium lilacinum: A minireview

Area of Science:

• Medical Mycology
• Infectious Diseases
• Clinical Microbiology

Background:

• Purpureocillium lilacinum (formerly Paecilomyces lilacinus) is a ubiquitous fungus increasingly recognized as a pathogen in humans and vertebrates.
• This opportunistic fungus causes a spectrum of infections, especially in immunocompromised individuals or post-surgery.
• Pathogenic mechanisms remain incompletely understood, posing diagnostic and therapeutic challenges.

Purpose of the Study:

• To review the clinical significance of Purpureocillium lilacinum infections.
• To highlight diagnostic approaches and therapeutic strategies.
• To underscore the need for further research into pathogenesis and treatment.

Main Methods:

• Literature review of Purpureocillium lilacinum infections.
• Analysis of clinical manifestations, diagnostic methods, and treatment outcomes.
• Evaluation of in vitro antifungal susceptibility data.

Main Results:

• Ocular, cutaneous, subcutaneous, and disseminated infections are common presentations.
• Voriconazole and posaconazole show good in vitro activity against Purpureocillium lilacinum.
• Mortality rates are significant, with 22% overall mortality and 46% of deaths attributed to the infection.

Conclusions:

• Accurate and timely diagnosis using molecular techniques is essential for effective management.
• Treatment often requires surgical debridement and antifungal therapy, with challenges due to intrinsic drug resistance.
• Further research is needed to elucidate pathogenesis and develop more effective diagnostic and therapeutic interventions.