Cutaneous Abscess Caused by Paecilomyces lilacinus in a Renal Transplant Patient / 대한의진균학회지

ABSTRACT

Paecilomyces lilacinus is an ubiquitous saprophytic fungus and very rarely pathogenic to the human. Although it has been reported to cause endophthalmitis, orbital cellulitis, prosthetic valve endocarditis, and pulmonary infection, cutaneous infection caused by Paecilomyces lilacinus has been rarely reported. A 46-year-old Korean man had asymptomatic slowly growing multiple cutaneous nodules on the left arm and wrist for 8 months. He received a renal transplantation in 1991 because of end-stage renal disease. Postoperatively, he has taken cyclosporin and deflazacort for immunosuppression. Physical examination revealed that the lesions were discrete or confluent, firm, elevated, well-defined fluctuating nodules. Histologic section showed multiple well-encapsulated intradermal abscesses with some foci of chronic granulomatous changes composed of lymphocytes, histiocytes and giant cells. PAS positive fungal hyphae and spores were also found. On the Sabouraud's dextrose agar media, the organism grew rapidly to form velvety lilac-colored colonies with shallow radiating furrows. Slide culture showed brush-like conidiophores ending in flask-shaped phialides carrying chain of conidia. Because of the poor response to the oral antifungal drug for 2 months, all the lesions were completely excised.