Invasive Infection With Purpureocillium lilacinum: A Case of Fungal Peritonitis

Purpureocillium lilacinum is an environmental mold that is a rare yet emerging cause of opportunistic infection in humans. When infection does occur, it most often involves ocular or cutaneous structures, although other infections are increasingly reported. P. lilacinum has notably been documented to display resistance to several mainstay antifungal drugs. Here, we describe a case of peritoneal dialysis-associated mold peritonitis due to P. lilacinum. The patient was a 15-year-old female presenting with abdominal pain and a clogged peritoneal dialysis catheter. Peritoneal fluid cultures displayed mold growth, which would subsequently be identified as P. lilacinum. After initial treatment failure with fluconazole, the patient was successfully treated with a long course of isavuconazole. This case highlights just the fourth reported case of P. lilacinum peritonitis in the medical literature and the first treated with isavuconazole.