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March 17, 2026The Brazilian Journal of Infectious DiseasesOpen Access

Surgical valve replacement and 12-week voriconazole resolve paravalvular abscess in Purpureocillium lilacinum endocarditis.

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Why the study?

Cases of rare invasive fungal diseases have increased worldwide, but reports of invasive human infection with Purpureocillium lilacinum remain scarce.

Population

A 59-year-old man with endocarditis caused by Purpureocillium lilacinum

Design

Case report

Key result

Surgical valve replacement and 12 weeks of voriconazole led to complete resolution of paravalvular abscess and clinical recovery in a patient with Purpureocillium lilacinum endocarditis.

Authors

RFRaphaela FerrariFCFlorencia ComelloJPJordan Monteiro Pinheiro

Discussion

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Member takes

Overview

Supports surgery plus voriconazole for P. lilacinum endocarditis; challenges consensus on its refractoriness.

Key Points

  • This case report examines an infection caused by the uncommon fungus Purpureocillium lilacinum in a patient with heart failure.
  • Detailed clinical presentation of a 59-year-old man with heart failure symptoms.
  • Transesophageal echocardiography to identify aortic valve vegetation and paravalvular abscess.
  • Isolated Purpureocillium lilacinum from intraoperative material and blood culture.
  • Treated the infection with voriconazole for 12 weeks.
  • Complete resolution of the paravalvular abscess was achieved.
  • Blood cultures showed clearance of fungal infection.
  • Patient experienced significant clinical recovery post-treatment.

Study Design

Type

Case Report (n=1)

Multicenter

No

Structured PICO

P
Population
A 59-year-old man with progressive symptoms of heart failure, Parkinson's disease, presenting with heart failure profile C requiring vasopressors and second-degree AV block (2:1), found to have aortic valve vegetation and paravalvular abscess.
I
Intervention
Surgical valve replacement and voriconazole for 12 weeks
O
Outcome
Resolution of paravalvular abscess, clearance of blood cultures, and clinical recovery

Purpureocillium lilacinum is a rare but possible cause of fungal endocarditis that can be successfully treated with surgical valve replacement and voriconazole.

Cite This Study

Ferrari et al. (2026) conducted a case report in Endocarditis caused by Purpureocillium lilacinum (n=1). Surgical valve replacement and voriconazole was evaluated on Resolution of paravalvular abscess, clearance of blood cultures and clinical recovery. Surgical valve replacement and 12 weeks of voriconazole led to complete resolution of paravalvular abscess and clinical recovery in a patient with Purpureocillium lilacinum endocarditis.

synapsesocial.com/papers/69b8ef12deb47d591b8c51bdhttps://doi.org/10.1016/j.bjid.2026.105182
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Cutaneous and Lymphangitic Infection Caused by Purpureocillium lilacinum in Immunocompromised Patients: A Case Report with a Narrative Review of the Literature2025
  2. 2Purpureocillium lilacinum-related endophthalmitis: case report2024 · 1 citations
  3. 3A Case of Deep Cutaneous Mycosis Caused by Purpureocillium lilacinum2024
  4. 4Aggressive <em>Purpureocillium lilacinum</em> Kerato-Endophthalmitis in a Diabetic Contact Lens Wearer Culminating in Enucleation: A Case Report and Review of the Literature2025
  5. 5Purpureocillium Lilacinum-Related Endophthalmitis: Case Report2024