Invasive Infection With Purpureocillium lilacinum: A Case of Fungal Peritonitis

<i>Purpureocillium lilacinum</i> is an environmental mold that is a rare yet emerging cause of opportunistic infection in humans. When infection does occur, it most often involves ocular or cutaneous structures, although other infections are increasingly reported. <i>P. lilacinum</i> has notably been documented to display resistance to several mainstay antifungal drugs. Here, we describe a case of peritoneal dialysis-associated mold peritonitis due to <i>P. lilacinum</i>. The patient was a 15-year-old female presenting with abdominal pain and a clogged peritoneal dialysis catheter. Peritoneal fluid cultures displayed mold growth, which would subsequently be identified as <i>P. lilacinum</i>. After initial treatment failure with fluconazole, the patient was successfully treated with a long course of isavuconazole. This case highlights just the fourth reported case of <i>P. lilacinum</i> peritonitis in the medical literature and the first treated with isavuconazole.