Shandong Provincial Hospital for Skin Diseases and Shandong Provincial Institute of Dermatology and Venereology, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China.
Am J Trop Med Hyg. 2023 Feb 20;108(4):693-695. doi: 10.4269/ajtmh.22-0608. Print 2023 Apr 5.
Purpureocillium lilacinum, widely used as a commercial biocontrol agent for controlling plant-parasitic nematodes, is an emerging opportunistic pathogen in humans and is increasingly reported, especially among immunocompromised patients. We report a classic case of cutaneous mycosis caused by P. lilacinum. A 51-year-old Chinese woman who received tacrolimus and glucocorticoid therapy for 3 years for nephrotic syndrome experienced recurrent papules, pustules, and ulceration on her right ring finger and subcutaneous nodules on her forearm 6 months ago. A lesion biopsy on the right ring finger revealed multiple epithelioid granulomas in the dermis and fat layer containing slender, pigmented fungal hyphae. The fungal culture showed the growth of violet floccose colonies. Lactophenol cotton blue culture stain demonstrated brush-like phialides, with a swollen basal part attached to chains of conidia. Sequencing of the internal transcribed spacer regions of ribosomal DNA, alignment with GenBank, and use of a Basic Local Alignment Search Tool analysis led to the identification of P. lilacinum. Treatment with oral voriconazole was successful.
深紫被毛孢，广泛用作防治植物寄生线虫的商业生物防治剂，是一种在人类中新兴的机会性病原体，越来越多的病例被报道，尤其是在免疫功能低下的患者中。我们报告了一例由深紫被毛孢引起的经典皮肤真菌感染病例。一名 51 岁的中国女性，因肾病综合征接受他克莫司和糖皮质激素治疗 3 年，6 个月前右手无名指出现反复丘疹、脓疱和溃疡，并在前臂出现皮下结节。右手无名指皮损活检显示真皮和脂肪层内存在多个上皮样肉芽肿，其中含有纤细、着色的真菌菌丝。真菌培养显示出紫罗兰色絮状菌落的生长。乳酚棉蓝培养染色显示出刷状的瓶梗，基部肿胀，附着在一串分生孢子上。核糖体 DNA 的内部转录间隔区序列的测序，与 GenBank 的比对，以及使用基本局部比对搜索工具分析，导致深紫被毛孢的鉴定。口服伏立康唑治疗成功。
