Paecilomyces lilacinus fungaemia in an AIDS patient: the importance of mycological diagnosis

SUMMARY FungaemiaduetoPaecilomyces lilacinusisgenerallynotconsideredinAIDSpatientsbecausethiscondition� isnotcategorisedasanAIDS-indicatorillness.�Wereportacaseofa�25-year-oldladywhopresentedto� ourhospitalwithGuillain-Barre�Syndrome,�withthesubsequentdevelopmentofrefractoryfungaemia,� multi-organfailureanddisseminatedintravascularcoagulopathy. AmphotericinBwasgivenasempirical� antifungaltherapy.�HIVscreeningwasreactiveandPaecilomyces lilacinuswasisolatedfromherblood.�The� fungaemiadidnotresolveafteroneweekofamphotericinBtreatment.�Theadditionofitraconazolewas� alsounsuccessfulinclearingthefungaemia.�AccuratemycologicaldiagnosisisimportantinthecareofAIDS� patientswithfungaemiabecauseoftheriskoftreatmentfailurewithempiricaltherapy.