title: Unusual case of cutaneous and synovial Paecilomyces lilacinus infection of hand successfully treated with voriconazole and review of published literature.
abstract: Paecilomyces lilacinus infection is rare and is found worldwide. The majority of infections occur in immunocompromised people. Among immunocompetent patients, cutaneous infections are the second most common site of infection but are difficult to treat because of antifungal resistance. We report a case of hand cutaneous involvement with synovitis in an immunocompetent patient that improved after treatment with oral voriconazole. To the best of our knowledge, there are only five published cases of cutaneous P.lilacinus infection, all in immunocompromised patient, treated with oral voriconazole. We review all previously reported cases.
authors.affiliation: Department of Internal Medicine, Union Memorial Hospital, Baltimore, MD 21218, USA. maryam.k.keshtkar-jahromi@medstar.net
authors.forename: Maryam
authors.initials: M
authors.lastname: Keshtkar-Jahromi
authors.forename: Arthur H
authors.initials: AH
authors.lastname: McTighe
authors.forename: Keith A
authors.initials: KA
authors.lastname: Segalman
authors.forename: Annette W
authors.initials: AW
authors.lastname: Fothergill
authors.forename: Wayne N
authors.initials: WN
authors.lastname: Campbell
mesh_terms: D000328:Adult; D000368:Aged; D000935:Antifungal Agents / Q000008:administration & dosage*; D002061:Bursa, Synovial / Q000473:pathology; D003881:Dermatomycoses / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology; D005260:Female; D006225:Hand / Q000473:pathology; D006651:Histocytochemistry; D006801:Humans; D008297:Male; D008853:Microscopy; D008875:Middle Aged; D009181:Mycoses / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology; D010143:Paecilomyces / Q000302:isolation & purification*; D011743:Pyrimidines / Q000008:administration & dosage*; D013585:Synovitis / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology; D016896:Treatment Outcome; D014230:Triazoles / Q000008:administration & dosage*; D065819:Voriconazole
chemical_list: D000935:Antifungal Agents; D011743:Pyrimidines; D014230:Triazoles; D065819:Voriconazole