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A Case of Deep Cutaneous Purpureocillium lilacinum Fungal Infection in an Immunocompetent Patient

Journal of Mycology and Infection 2019년 24권 2호 p.52 ~ 57
김효진, 조경제, 김종욱, 진순우, 박소희, 문승현, 설정은, 신정환,
소속 상세정보
김효진 ( Kim Hyo-Jin ) - Inje University College of Medicine Busan Paik Hospital Department of Dermatology
조경제 ( Cho Gyeong-Je ) - Inje University College of Medicine Busan Paik Hospital Department of Dermatology
김종욱 ( Kim Jong-Uk ) - Inje University College of Medicine Busan Paik Hospital Department of Dermatology
진순우 ( Jin Sun-Woo ) - Inje University College of Medicine Busan Paik Hospital Department of Dermatology
박소희 ( Park So-Hee ) - Inje University College of Medicine Busan Paik Hospital Department of Dermatology
문승현 ( Moon Seung-Hyun ) - Inje University College of Medicine Busan Paik Hospital Department of Dermatology
설정은 ( Seol Jung-Eun ) - Inje University College of Medicine Busan Paik Hospital Department of Dermatology
신정환 ( Shin Jeong-Hwan ) - Inje University College of Medicine Busan Paik Hospital Department of Laboratory Medicine

Abstract


Purpureocillium is a genus of saprophytic fungi that is commonly found in soil or rotting material. Although rarely a pathogen in humans, it can cause serious infections in immunocompromized patients. An 85-year-old woman presented with a 2-week history of pruritic erythematous plaques with yellowish crusts on her right forearm and dorsal hand. Histopathological analysis identified fungal hyphae and spores in the dermis, and Purpureocillium lilacinum was identified through tissue culture, polymerase chain reaction, and DNA sequencing. The skin lesion barely responded to 4 weeks of itraconazole treatment but improved upon the addition of terbinafine. The skin lesion was completely cured after 12 weeks, with no recurrence to date. Here, we report a rare deep cutaneous fungal infection caused by P. lilacinum in an immunocompetent patient and postulate that, in this case, the patient’s agricultural lifestyle increased the possibility of P. lilacinum infection.

키워드

Deep fungal infection; Immunocompetent host; Purpureocillium lilacinum

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