Fungal infections following dermal filler injections are exceedingly rare, particularly in immunocompetent individuals. Among these, Aspergillus species–related infections have been scarcely reported. We describe a case of Aspergillus fumigatus infection in a 24‐year‐old immunocompetent woman who developed persistent lip nodules and swelling four months after receiving hyaluronic acid–based lip filler injections administered by a nonmedical provider. The patient failed multiple courses of empirical antibiotics and systemic corticosteroids, with progressive worsening of symptoms. Histopathological examination revealed granulomatous inflammation with fungal hyphae, and fungal culture confirmed Aspergillus fumigatus , which demonstrated resistance to itraconazole on antifungal susceptibility testing. The patient was successfully treated with intravenous voriconazole, resulting in complete clinical resolution. This case highlights the diagnostic challenges of delayed‐onset filler‐related nodules, underscores the importance of early biopsy and fungal investigation, and emphasizes the role of antifungal susceptibility testing in guiding effective therapy.
Khodeir et al. (Thu,) studied this question.