A Rare Case of Nasal Septal Perforation Due to Purpureocillium lilacinum: Case Report and Review.

Perforations of nasal septum are fairly frequent with an incidence of about 0.9 % and may lead to morbidity than mortality. Common causes are trauma (iatrogenic occasionally nose picking), malignancy, inflammations and infections such as tuberculosis, syphilis, Wegener's granulomatosis, sarcoidosis and fungal infections. Paranasal fungal sinusitis is frequently encountered in clinical practice in both immunocompromised and immunocompetent individuals. Nasal septal perforations caused by species of Aspergillus and Fusarium have been documented. We report a case of nasal septal perforation in a 35-years-old immunocompetent male patient due to Purpureocillium lilacinum, a soil and environmental fungus and an emerging pathogen, which is known to cause various infections in humans with normal and deficient immune system. Fungal aetiology was diagnosed by histopathology and direct smear examination and confirmed by culture. Patient was treated with voriconozole, following Antifungal susceptibility testing (AFST), to which the patient is responding.