Purpureocillium lilacinum an emergent pathogen: antifungal susceptibility of environmental and clinical strains

Pulmonary lesions in Virginia opossums (Didelphis virginiana): Characterizing fungal pneumonia associated with Purpureocillium lilacinum

Several pulmonary lesions have been described in Virginia opossums (Didelphis virginiana), but fungal pneumonia in this species is largely unrecognized. We retrospectively analyzed gross and histologic pulmonary findings in 28 opossums from Louisiana. Lung sections were evaluated for fungal organisms, associated histologic changes, and other concurrent pulmonary lesions. Seventy-five percent of opossums (21/28) had pulmonary fungal organisms, and gross lesions were characteristic, consisting of patchy to generalized, indistinct, pinpoint, light-yellow parenchymal foci. These areas corresponded to alveoli filled with foamy macrophages and multinucleated giant cells that contained distinctive intracytoplasmic budding cells, which were 3 to 5 × 2 µm, ovoid to elongate, and argyrophilic, as well as rare pleomorphic fungal hyphae. Purpureocillium lilacinum was identified based on pulmonary fungal isolation and/or fungal internal transcribed spacer 2 (ITS-2) polymerase chain reaction (PCR) and sequencing in a subset of cases. Other findings included verminous pneumonia (13/28, 46%), pulmonary neoplasms (7/28, 25%), bacterial pneumonia (5/28, 18%), and endogenous lipid pneumonia (2/28, 7%). The histologic severity of fungal infections was significantly positively correlated with gross lesion severity and abundance of alveolar macrophages (P-values both < .0001). Identification of fungal pneumonia was as likely as verminous pneumonia, and fungal pneumonia was significantly more severe in opossums with concurrent verminous pneumonia (P = .0011). Despite the pulmonary changes, respiratory signs were rarely noted, even in severely affected cases. This is the first report associating P. lilacinum with fungal pneumonia in opossums from Louisiana. The characteristic gross and histologic lesions should prompt diagnosticians to closely evaluate for fungal organisms and consider P. lilacinum as a differential diagnosis.

Potential Functions and Transmission Dynamics of Fungi Associated with Anoplophora glabripennis Across Different Life Stages, Between Sexes, and Between Habitats

The fungi residing in the gut and associated habitats play a crucial role in the growth and development of Anoplophora glabripennis (Motschulsky) (Coleoptera: Cerambycidae), a wood-boring pest. Yet, how they are acquired and maintained across generations, and their respective roles throughout the life cycle, remain unknown. To this end, we used high-throughput ITS sequencing analysis to characterize the fungal composition and diversity associated with A. glabripennis across three different life stages, between sexes, and between its habitats. Overall, the fungi composition was stage specific, with adult gut communities being more diverse than those of larvae and eggs. Male fungal communities differed significantly, while frass and female communities were more similar to each other. The top 10 most abundant genera were investigated, with Fusarium consistently observed in all samples and exhibiting the highest overall abundance. Function predictions revealed the presence of potentially beneficial fungi that may support A. glabripennis invasion across all groups. Additionally, we observed complex network structures in the fungal communities associated with eggs and males, and stronger positive correlations in those of eggs and newly hatched larvae. Source tracking analysis suggested that these fungi were vertically transmitted, following a transmission pathway of 'female gut-frass-egg-larval gut', occurring via frass deposited in oviposition sites. Our findings provide a nuanced understanding of the intricate interactions among plants, insects, and fungi, shedding light on the acquisition, maintenance, and roles of gut-associated fungi in A. glabripennis.

Successful treatment of Purpureocillium lilacinum pulmonary infection with isavuconazole: A case report

BACKGROUND

Purpureocillium lilacinum (P. lilacinum) is a saprophytic fungus widespread in soil and vegetation. As a causative agent, it is very rarely detected in humans, most commonly in the skin.

CASE SUMMARY

In this article, we reported the case of a 72-year-old patient with chronic lymphocytic leukemia who was admitted with cough and fever. Computed tomography revealed an infection in the right lower lobe. Bronchoalveolar lavage fluid culture and metagenomic next-generation sequencing were ultimately confirmed to have a pulmonary infection with P. lilacinum. She was eventually discharged with good outcomes after treatment with isavuconazole.

CONCLUSION

Pulmonary infection with P. lilacinum was exceedingly rare. While currently there are no definitive therapeutic agents, there are reports of high resistance to amphotericin B and fluconazole and good sensitivity to second-generation triazoles. The present report is the first known use of isavuconazole for pulmonary P. lilacinum infection. It provides new evidence for the characterization and treatment of clinical P. lilacinum lung infections.

Cutaneous Hyalohyphomycosis and Its Atypical Clinical Presentations in Immunosuppressed Patients

There has been a substantial increase in the number of cases of invasive fungal infections worldwide, which is associated with a growing number of immunosuppressed patients and a rise in antifungal resistance. Some fungi that were previously considered harmless to humans have become emerging pathogens. One of them is Purpureocillium lilacinum, a ubiquitous filamentous fungus commonly found in the environment, especially in the air and soil. P. lilacinum belongs to a bigger group of hyaline fungi that cause hyalohyphomycosis, a fungal infection caused by fungi with colorless hyphae. Although this is a heterogeneous group of fungi, there are similarities regarding their ubiquity, ways of transmission, affected patients, and difficulties in diagnostics and treatment. In hyalohyphomycosis, the skin is one of the most affected organs, which is why the involvement of dermatologists is crucial for the initial assessment, since the timely recognition and early diagnosis of this condition can prevent life-threatening infections and death. In this review, we covered cutaneous hyalohyphomycosis caused by P. lilacinum and other fungi in the same group, including Fusarium, Penicilium, Scedosporium, Scopulariopsis, Acremonium, and Trichoderma genera.

Lymphadenitis caused by Purpureocillium lilacinum in a patient with CARD9 deficiency

We hereby make the first report of a case of mycosis caused by Purpureocillium lilacinum in CARD9 deficiency. A 40-year-old woman complained of lymph node swellings in the left cervical area. She also had chronic mucocutaneous candidiasis (CMC), and was found to have CARD9 deficiency. Lymphadenitis by P. lilacinum was confirmed. The diagnosis was difficult, as culturing the biopsy specimen at a cautiously selected temperature (25 °C) and genetic analysis were both required. Oral administration of voriconazole improved her lymphadenopathy.