Voriconazole-resistant Purpureocillium lilacinum endophthalmitis in an agricultural worker: A case report

Medical Mycology Case Reports 2026 Open access

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Authors: Qingqing Xu, Jiachun Su, Zhewei Sun, Fan Yang, Ying Li
DOI: 10.1016/j.mmcr.2026.100783
Cited by: 1
References: 10

Abstract

ABSTRACT Purpureocillium lilacinum is an emerging opportunistic pathogen with a distinct ocular tropism, most commonly causing keratitis. We report a case of refractory endophthalmitis in an agricultural worker caused by a voriconazole-resistant strain of P. lilacinum with a detailed genomic sequence. After failure of initial voriconazole therapy, the patient was successfully managed with surgical intervention and a novel, multi-route posaconazole regimen, comprising systemic (intravenous and oral), topical, and intravitreal administration. This case underscores the emergence of voriconazole resistance in P. lilacinum endophthalmitis and demonstrates the successful use of a comprehensive posaconazole-based therapeutic strategy

Fields of Study & Subjects

Ocular Infections and Treatments Legionella and Acanthamoeba research Antifungal resistance and susceptibility

Publication details

Journal / source
Medical Mycology Case Reports
Publisher
Elsevier BV
Volume
52
Pages
100783–100783
Publication date
4 April 2026
Language
EN