%0 Journal Article
%T Paecilomyces variotii as an Emergent Pathogenic Agent of Pneumonia
%A Bruna Steiner
%A Valerio R. Aquino
%A Alessandra A. Paz
%A Lucia Mariano da Rocha Silla
%A Alexandre Zavascki
%A Luciano Z. Goldani
%J Case Reports in Infectious Diseases
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/273848
%X Paecilomyces variotii is a commonly occurring species in air and food, and it is also associated with many types of human infections. Pneumonia due to Paecilomyces variotii has been rarely reported in the medical literature. The authors report a 48-year-old patient with refractory lymphoma who underwent allogenic hematopoietic cell transplantation and developed pneumonia due to Paecilomyces variotii. They also review the published case reports of pneumonia caused by this fungus. 1. Introduction Paecilomyces species are saprophytic fungi and are uncommon pathogens that can produce serious infections in immunocompromised patients and occasionally in immunocompetent hosts [1]. Paecilomyces is of clinical interest because of its pathogenicity and resistance to antifungal agents. Paecilomyces variotii is a commonly occurring species in air and food, and it is also associated with many types of human infections, such as fungemia, endocarditis, peritonitis, and osteomyelitis [2¨C9]. Pneumonia due to Paecilomyces variotii has been rarely reported in the medical literature. Here, we report a patient with refractory lymphoma who underwent allogenic hematopoietic cell transplantation and developed pneumonia due to Paecilomyces variotii. They also review the case reports of pneumonia caused by this fungus. 2. Case Report A 48-year-old Brazilian woman with the diagnosis of non-Hodgkin¡¯s lymphoma underwent chemotherapy and autologous hematopoietic cell transplantation in 2010. The lymphoma recurred, and the patient was admitted to the hospital to undergo chemotherapy and allogeneic hematopoietic cell transplantation in October 2011. She was conditioned with busulfan, melphalan, and gemcitabine and received peripheral blood stem cell (PBSC) from HLA sibling identical donor. Patient underwent prophylaxis of acute graft versus-host disease (aGVHD) with cyclosporine and methotrexate engraftment occurred on day 14 after transplant. During this period, she presented with febrile neutropenia and mucositis, which resolved after treatment with broad-spectrum antibiotics. On day 24 after transplant, the patient presented with probable pulmonary aspergillosis, as determined by an elevated serum galactomannan level. The patient was treated initially with intravenous micafungin (150£¿mg once per day) and was switched to oral voriconazole (200£¿mg twice per day). She also presented with cutaneous and intestinal Grade II aGVHD which improved after treatment with methyl prednisone 2£¿mg/kg. Voriconazole was suspended in December 2011 after 8 weeks of treatment. She was discharged on day
%U http://www.hindawi.com/journals/criid/2013/273848/