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Cutaneous hyalohyphomycosis caused by Paecilomyces lilacinus: report of three cases and review of the literature

Authors

  • Virginia C. Hall MD,

    Corresponding author
    1. From the Department of Dermatology, Mayo Clinic, Jacksonville, FL and the Department of Dermatology, Mayo Clinic, Rochester, MN, USA
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  • Sanjiva Goyal MD,

    1. From the Department of Dermatology, Mayo Clinic, Jacksonville, FL and the Department of Dermatology, Mayo Clinic, Rochester, MN, USA
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  • Mark D. P. Davis MD,

    1. From the Department of Dermatology, Mayo Clinic, Jacksonville, FL and the Department of Dermatology, Mayo Clinic, Rochester, MN, USA
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  • John S. Walsh MD

    1. From the Department of Dermatology, Mayo Clinic, Jacksonville, FL and the Department of Dermatology, Mayo Clinic, Rochester, MN, USA
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Virginia C. Hall, md Department of Dermatology Mayo Clinic 4500 San Pablo Road Jacksonville FL 32224 USA

Abstract

Cutaneous infection with Paecilomyces lilacinus is encountered worldwide, with most infections occurring either iatrogenically or in immunocompromised hosts. We report three cases of cutaneous hyalohyphomycosis caused by P. lilacinus, one of which occurred in an immunocompetent individual. In addition, we review the 17 cases previously reported in the literature. Although this infection can be difficult to treat, most cases are not fatal. Most cases responded well to systemic azole antifungal agents, either alone or in association with surgical excision of the lesion. Paecilomyces species are saprophytic fungi found in soil and decaying organic matter. Infection in humans is rare, but when it occurs treatment is often difficult. We report three cases of cutaneous hyalohyphomycosis caused by P. lilacinus and review the 17 previously reported cases in which the clinical history and response to therapy were described.

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