Paecilomyces lilacinus fungemia in an adult bone marrow transplant recipient

K. M. Chan-Tack, C. L. Thio, N. S. Miller, C. L. Karp, C. Ho, William G. Merz

Research output: Contribution to journalArticle

Abstract

Paecilomyces lilacinus a rare fungal pathogen in humans. We report a case of fungemia caused by P. lilacinus in a non-neutropenic adult, 120 days after bone marrow transplant. The patient's primary risk factor was the presence of an indwelling vascular catheter. Her initial clinical course was characterized by fever, chills, and rigors. Blood cultures from the central line and peripheral veins were positive, as was a peripheral specimen drawn after removal of the catheter. Two initial peripheral specimens were positive for P. lilacinus only by blind subculture and/or sustained incubation. She developed peripheral pulmonary nodules following the fungemia, thus raising the possibility of disseminated disease, but definitive diagnosis was confounded by Pseudomonas bacteremia. The nodules cleared and she recovered following removal of the central line and treatment with amphotericin B and 5-fluorocytosine, despite in vitro resistance to these antifungal drugs. This case underscores the increasing importance of P. lilacinus as a human pathogen capable of producing disease in immunocompetent, as well as in immunocompromised hosts. Also of note is that blood culture systems may require extended incubation or subcultures in order to detect fungi.

Original languageEnglish (US)
Pages (from-to)57-60
Number of pages4
JournalMedical mycology
Volume37
Issue number1
DOIs
StatePublished - Feb 1 1999

Keywords

  • Fungemia
  • Paecilomyces lilacinus

ASJC Scopus subject areas

  • Infectious Diseases

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