CTICasesPurpureocillium lilacinum Cavitary Pulmonary Infection
Imaging findings
In a roughly 70-year-old patient with a history of asthma, chest radiograph shows a cavitation with an air-fluid level and nodules in the right upper lung; CT confirms several cavitary nodules in the right upper lung with relatively clear lung bases. A dilated trachea and proximal bronchi are also present.
Key takeaways
Culture grew Purpureocillium lilacinum, formerly classified as Paecilomyces lilacinus, an unusual fungal cause of cavitary pulmonary nodules with very few prior reported cases; the patient's only apparent risk factor was tracheobronchomegaly, which may predispose to fungal colonization and infection, and there was no history of steroid use, underscoring that this organism can cause cavitary lung disease even without classic immunosuppression.
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