Chapter 11. Purpureocillium lilacinum: From Environment to Emergent Human Pathogens

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Danielly Corrêa-Moreira1,2, Cintia de Moraes Borbaand Manoel Marques Evangelista Oliveira2
1Department of Education, Post-Doctoral in Clinical Research of Infectious Diseases, Evandro Chagas National Institute of Infectious Diseases, Fiocruz, Rio de Janeiro, Brazil
2Laboratory of Taxonomy, Biochemistry and Bioprospecting of Fungi, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, Brazil

Part of the book: The Book of Fungal Pathogens

Abstract

Purpureocillium lilacinum is a filamentous and hyaline fungus saprophytic in the soil, air and decomposing material. It may produce mycotoxins and also deterioration of food, grain and paper. The consequences of fungal colonization on different substrates as food is the loss of nutritional value, structure and taste and the possibility of producing toxic secondary metabolites that may result in medical problems. The fungal infection caused by it, and by other species, is called hyalohyphomycosis, characterized by the presence of a hyaline mycelium in the host. P. lilacinum although described as having moderate virulence is capable of causing disseminated hyalohyphomycosis, frequently recurrent, in immunosuppressed adults. However, in the last decade, there has been a significant increase in cases of human hyalohyphomycosis in immunocompetent individuals. The most frequent clinical manifestations are ocular infections and cutaneous/subcutaneous, but endocarditis, pneumonia, fungemia, onychomycosis, among others, are also reported. The diagnosis of the disease is done by macro and microculture analysis. There is not a standard treatment, but sequential and/or associated adminstration of different azoles is necessary. In vitro antifungal susceptibility tests have demonstrated that amphotericin B, fluconazole, flucytosine and itraconazole were least active against P. lilacinum. Posaconazole and voriconazole showed the best results. Animal models, mainly murine ones, have been used to demonstrate the ability of this fungus to cause experimental infection and understand the mechanisms involved in the host-parasite relationship. This chapter is a review of the literature on P. lilacinum, which is often mistakenly regarded as a contaminating fungus with no medical importance.

Keywords: Purpureocillium lilacinum, saprophyte fungus, emergent pathogen, clinical manifestations, diagnosis, treatment, in vitro antifungal susceptibility, experimental models, occupational risks


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