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Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 16, 2025; 13(29): 108582
Published online Oct 16, 2025. doi: 10.12998/wjcc.v13.i29.108582
Purpureocillium lilacinum: A minireview
Daisuke Usuda, Daiki Furukawa, Rikako Imaizumi, Rikuo Ono, Yuki Kaneoka, Eri Nakajima, Yuto Sugawara, Runa Shimizu, Riki Sakurai, Shun Matsubara, Risa Tanaka, Makoto Suzuki, Shintaro Shimozawa, Yuta Hotchi, Ippei Osugi, Risa Katou, Sakurako Ito, Kentaro Mishima, Akihiko Kondo, Keiko Mizuno, Hiroki Takami, Takayuki Komatsu, Tomohisa Nomura, Manabu Sugita
Daisuke Usuda, Daiki Furukawa, Rikako Imaizumi, Rikuo Ono, Yuki Kaneoka, Eri Nakajima, Yuto Sugawara, Runa Shimizu, Riki Sakurai, Shun Matsubara, Risa Tanaka, Makoto Suzuki, Shintaro Shimozawa, Yuta Hotchi, Ippei Osugi, Risa Katou, Sakurako Ito, Kentaro Mishima, Akihiko Kondo, Keiko Mizuno, Hiroki Takami, Takayuki Komatsu, Tomohisa Nomura, Manabu Sugita, Department of Emergency and Critical Care Medicine, Juntendo University Nerima Hospital, Nerima 177-8521, Tokyo, Japan
Takayuki Komatsu, Department of Sports Medicine, Faculty of Medicine, Juntendo University, Bunkyo 113-8421, Tokyo, Japan
Author contributions: Usuda D wrote the manuscript. Furukawa D, Imaizumi R, Ono R, Kaneoka Y, Nakajima E, Sugawara Y, Shimizu R, Sakurai R, Matsubara S, Tanaka R, Suzuki M, Shimozawa S, Hotchi Y, Osugi I, Katou R, Ito S, Mishima K, Kondo A, Mizuno K, Takami H, Komatsu T, Nomura T, and Sugita M proofread and revised the manuscript; all authors approved the final version to be published.
Supported by The Japan Society for the Promotion of Science KAKENHI Grant, No. 24K15491.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Daisuke Usuda, MD, PhD, Associate Professor, Department of Emergency and Critical Care Medicine, Juntendo University Nerima Hospital, 3-1-10 Takanodai, Nerima 177-8521, Tokyo, Japan. d.usuda.qa@juntendo.ac.jp
Received: April 18, 2025
Revised: June 17, 2025
Accepted: August 4, 2025
Published online: October 16, 2025
Processing time: 133 Days and 0.8 Hours
Abstract

Purpureocillium lilacinum (formerly Paecilomyces lilacinus) is a hyaline hyphomycete with a ubiquitous distribution. In the last decade this fungus has been increasingly found as the causal agent of infections in humans and other vertebrates. It is an emerging opportunistic pathogen and is increasingly reported, and can cause a wide spectrum of clinical manifestations, especially among immunocompromised patients or following surgical procedures. The pathogenic mechanisms are not yet fully understood. Ocular and cutaneous/subcutaneous infections are the most familiar clinical presentations, and these can also cause disseminated infections. Early and accurate species identification and susceptibility testing are vital. In general, surgical debridement combined with antifungal drug therapy, or the correction of predisposing factors, are usually required to obtain improvement. Infections present a therapeutic challenge, as they have intrinsic resistance to many antifungal agents, but voriconazole and posaconazole are good in vitro activity. The overall mortality was 22% and death was attributed to the infection in 46% of cases. Accurate diagnoses can be achieved through newer molecular biological techniques, and these can lead to appropriate management of infections due to this organism. Future studies should ideally aim to elucidate pathogenesis and determine more effective diagnoses and effective antifungal treatment.

Keywords: Purpureocillium lilacinum; Hyalohyphomycosis; Immunocompromised status; Identification; Treatment; Minireview

Core Tip: Purpureocillium lilacinum (formerly Paecilomyces lilacinus) is a hyaline hyphomycete with a ubiquitous distribution. In the last decade this fungus has been increasingly found as the causal agent of an emerging opportunistic pathogen, which can cause a wide spectrum of clinical manifestations, especially among immuno-compromised patients or following surgical procedures. The pathogenic mechanisms are not yet fully understood. Early and accurate species identification and susceptibility testing are vital. In general, surgical debridement combined with antifungal drug therapy, or the correction of predisposing factors, are usually required to obtain improvement.