Complicated Multiple Organ Infection of and Varicella-zoster Virus Infection in a Patient with Evans' Syndrome

Overview

Journal Blood Sci

Date 2022 Aug 12

PMID 35957666

Authors

Xiangrong Hu

Li Zhang

Qingsong Lin

Fengkui Zhang

Xin Zhao

Affiliations

Soon will be listed here.

Abstract

( is a rare pathogenic fungus, which mainly involves immunocompromised individuals. Here, we report a case of complicated multiple-organ infections involving skin, lungs, and spleen in a 63-year-old female with Evans' syndrome after 9 months of glucocorticoid treatment. Microbial examinations of skin biopsy and blood samples revealed infections. Posaconazole was effective in this patient. During anti-fungi treatment, she developed varicella-zoster virus infection and was diagnosed through next-generation sequencing examination. In conclusion, may affect different organ systems and is susceptible to posaconazole treatment. The molecular-based methods like microbial cell-free DNA sequencing could provide accurate and timely identification of a wide range of infections.

References

Chew R, Dorman A, Woods M . Purpureocillium lilacinum keratitis: a case series and review of the literature. Can J Ophthalmol. 2016; 51(5):382-385. DOI: 10.1016/j.jcjo.2016.05.013. View

Luangsa-Ard J, Houbraken J, van Doorn T, Hong S, Borman A, Hywel-Jones N . Purpureocillium, a new genus for the medically important Paecilomyces lilacinus. FEMS Microbiol Lett. 2011; 321(2):141-9. DOI: 10.1111/j.1574-6968.2011.02322.x. View

Jing C, Chen H, Liang Y, Zhong Y, Wang Q, Li L . Clinical Evaluation of an Improved Metagenomic Next-Generation Sequencing Test for the Diagnosis of Bloodstream Infections. Clin Chem. 2021; 67(8):1133-1143. DOI: 10.1093/clinchem/hvab061. View

Wang L, Guo W, Shen H, Guo J, Wen D, Yu Y . Plasma Microbial Cell-Free DNA Sequencing Technology for the Diagnosis of Sepsis in the ICU. Front Mol Biosci. 2021; 8:659390. PMC: 8194294. DOI: 10.3389/fmolb.2021.659390. View

Pastor F, Guarro J . Clinical manifestations, treatment and outcome of Paecilomyces lilacinus infections. Clin Microbiol Infect. 2006; 12(10):948-60. DOI: 10.1111/j.1469-0691.2006.01481.x. View

Blauwkamp T, Thair S, Rosen M, Blair L, Lindner M, Vilfan I . Analytical and clinical validation of a microbial cell-free DNA sequencing test for infectious disease. Nat Microbiol. 2019; 4(4):663-674. DOI: 10.1038/s41564-018-0349-6. View

Raghavan R, Chithra G, Fernandez S, Shamana Suryanarayana B, Singh R . An unusual case of hyalohyphomycosis due to in a patient with myasthenia gravis. Curr Med Mycol. 2018; 4(2):36-39. PMC: 6181066. DOI: 10.18502/cmm.4.2.62. View

Arnoldner M, Kheirkhah A, Jakobiec F, Durand M, Hamrah P . Successful treatment of Paecilomyces lilacinus keratitis with oral posaconazole. Cornea. 2014; 33(7):747-9. PMC: 4071292. DOI: 10.1097/ICO.0000000000000143. View

Salazar-Gonzalez M, Violante-Cumpa J, Alfaro-Rivera C, Villanueva-Lozano H, Trevino-Rangel R, Gonzalez G . Purpureocillium lilacinum as unusual cause of pulmonary infection in immunocompromised hosts. J Infect Dev Ctries. 2020; 14(4):415-419. DOI: 10.3855/jidc.12235. View

10.

Carey J, DAmico R, Sutton D, Rinaldi M . Paecilomyces lilacinus vaginitis in an immuno-competent patient. Emerg Infect Dis. 2003; 9(9):1155-8. PMC: 3016773. DOI: 10.3201/eid0909.020654. View

11.

Rimawi R, Carter Y, Ware T, Christie J, Siraj D . Use of voriconazole for the treatment of Paecilomyces lilacinus cutaneous infections: case presentation and review of published literature. Mycopathologia. 2013; 175(3-4):345-9. DOI: 10.1007/s11046-012-9610-3. View

12.

Van Schooneveld T, Freifeld A, Lesiak B, Kalil A, Sutton D, Iwen P . Paecilomyces lilacinus infection in a liver transplant patient: case report and review of the literature. Transpl Infect Dis. 2007; 10(2):117-22. DOI: 10.1111/j.1399-3062.2007.00248.x. View

13.

Decker S, Sigl A, Grumaz C, Stevens P, Vainshtein Y, Zimmermann S . Immune-Response Patterns and Next Generation Sequencing Diagnostics for the Detection of Mycoses in Patients with Septic Shock-Results of a Combined Clinical and Experimental Investigation. Int J Mol Sci. 2017; 18(8). PMC: 5578184. DOI: 10.3390/ijms18081796. View

14.

Tara A, Kobayashi T, Kohmoto R, Fukumoto M, Sato T, Kida T . A Case of Fungal Endophthalmitis Caused by that Might Have Spread from the Sclera into the Intraocular Space. Case Rep Ophthalmol. 2020; 11(2):256-262. PMC: 7383179. DOI: 10.1159/000508389. View

15.

Saghrouni F, Saidi W, Ben Said Z, Gheith S, Said M, Ranque S . Cutaneous hyalohyphomycosis caused by Purpureocillium lilacinum in an immunocompetent patient: case report and review. Med Mycol. 2013; 51(6):664-8. DOI: 10.3109/13693786.2012.757656. View

16.

Ezzedine K, Belin E, Guillet S, DAlmeida M, Droitcourt C, Accocebery I . Cutaneous hyphomycosis due to Paecilomyces lilacinus. Acta Derm Venereol. 2011; 92(2):156-7. DOI: 10.2340/00015555-1179. View

17.

Khan Z, Ahmad S, Al-Ghimlas F, Al-Mutairi S, Joseph L, Chandy R . Purpureocillium lilacinum as a cause of cavitary pulmonary disease: a new clinical presentation and observations on atypical morphologic characteristics of the isolate. J Clin Microbiol. 2012; 50(5):1800-4. PMC: 3347118. DOI: 10.1128/JCM.00150-12. View

18.

Wessolossky M, Haran J, Bagchi K . Paecilomyces lilacinus olecranon bursitis in an immunocompromised host: case report and review. Diagn Microbiol Infect Dis. 2008; 61(3):354-7. DOI: 10.1016/j.diagmicrobio.2008.02.003. View

19.

Espinel-Ingroff A, Chaturvedi V, Fothergill A, Rinaldi M . Optimal testing conditions for determining MICs and minimum fungicidal concentrations of new and established antifungal agents for uncommon molds: NCCLS collaborative study. J Clin Microbiol. 2002; 40(10):3776-81. PMC: 130896. DOI: 10.1128/JCM.40.10.3776-3781.2002. View

20.

Grumaz S, Stevens P, Grumaz C, Decker S, Weigand M, Hofer S . Next-generation sequencing diagnostics of bacteremia in septic patients. Genome Med. 2016; 8(1):73. PMC: 4930583. DOI: 10.1186/s13073-016-0326-8. View