{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T20:18:22Z","timestamp":1762201102283,"version":"build-2065373602"},"reference-count":30,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T00:00:00Z","timestamp":1762128000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JoF"],"abstract":"<jats:p>Introduction:\u00a0Purpureocillium lilacinum (formerly Paecilomyces lilacinus) is an emerging, saprophytic fungus known to cause severe, treatment-refractory ocular infections. It is notoriously clinically resistant to several common antifungal agents, including amphotericin B. Risk factors for Purpureocillium lilacinum (P. lilacinum) keratitis include contact lens wear, ocular trauma, and local or systemic immunosuppression. Case Presentation: We describe the clinical course of a 70-year-old male with type 2 diabetes mellitus and a history of long-term soft contact lens use who presented with a right corneal ulcer. Despite initial treatment with topical voriconazole, the infection progressed over two months to involve the entire globe, resulting in intractable endophthalmitis. Microbiological analysis of corneal scrapings identified P. lilacinum, confirmed by MALDI-TOF mass spectrometry and ITS sequencing. Despite the addition of systemic voriconazole, the patient\u2019s condition deteriorated, leading to a painful blind right eye which ultimately needed enucleation. Conclusions: This case highlights the aggressive potential of P. lilacinum in a host with multiple risk factors. It underscores the critical need for a high index of suspicion, rapid and accurate mycological diagnosis, and immediate, aggressive management. The therapeutic challenges, including intrinsic and emerging antifungal resistance, often necessitate early surgical intervention to prevent catastrophic outcomes.<\/jats:p>","DOI":"10.3390\/jof11110789","type":"journal-article","created":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T19:30:27Z","timestamp":1762198227000},"page":"789","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Aggressive Purpureocillium lilacinum Kerato-Endophthalmitis in a Diabetic Contact Lens Wearer Culminating in Enucleation: A Case Report and Review of the Literature"],"prefix":"10.3390","volume":"11","author":[{"given":"Sara","family":"Calendino","sequence":"first","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON N6A 3K7, Canada"},{"name":"London Health Science Centre, London, ON N6A 5W9, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Kenna","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON N6A 3K7, Canada"},{"name":"London Health Science Centre, London, ON N6A 5W9, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hetal","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON N6A 3K7, Canada"},{"name":"London Health Science Centre, London, ON N6A 5W9, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jenny","family":"Vereecken","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON N6A 3K7, Canada"},{"name":"London Health Science Centre, London, ON N6A 5W9, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3978-1823","authenticated-orcid":false,"given":"Fatima","family":"Almutawah","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON N6A 3K7, Canada"},{"name":"London Health Science Centre, London, ON N6A 5W9, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeff","family":"Fuller","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON N6A 3K7, Canada"},{"name":"London Health Science Centre, London, ON N6A 5W9, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3487-2715","authenticated-orcid":false,"given":"Sameer","family":"Elsayed","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON N6A 3K7, Canada"},{"name":"London Health Science Centre, London, ON N6A 5W9, Canada"},{"name":"Department of Infectious Diseases, Schulich School of Medicine and Dentistry, Western University, London, ON N6A 3K7, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johan","family":"Delport","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON N6A 3K7, Canada"},{"name":"London Health Science Centre, London, ON N6A 5W9, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1279-1738","authenticated-orcid":false,"given":"Ruchika","family":"Bagga","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON N6A 3K7, Canada"},{"name":"London Health Science Centre, London, ON N6A 5W9, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Khan, M., and Tanaka, K. 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