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Penicillium marneffei infection in patients infected with human immunodeficiency virus
K Supparatpinyo1, S Chiewchanvit, P Hirunsri
1Faculty of Medicine, Chiang Mai University, Thailand.
Abstract:
From June 1990 to August 1991, 21 patients infected with the human immunodeficiency virus (HIV) presented with systemic mycosis caused by Penicillium marneffei. Between August 1987 and August 1991, only five patients were observed who had P. marneffei infection but not HIV infection. The clinical presentation included fever, cough, and generalized papular skin lesions. For 11 of these 21 patients, the presumptive diagnosis of P. marneffei infection could be made by microscopic examination of Wright's-stained bone marrow aspirate and/or touch smears of skin specimens obtained by biopsy several days before the results of culture were available. Initial clinical response to treatment with either parenteral amphotericin B or oral itraconazole was favorable in most patients. Epidemiological and clinical evidence suggest that this systemic mycosis is caused by an important opportunistic pathogen and that it should be included in the differential diagnosis of AIDS, at least for countries in areas of endemicity, i.e., Southeast Asia and China.
Insights
Human immunodeficiency virus (HIV) patients frequently developed Penicillium marneffei systemic mycosis. Early diagnosis via microscopy aids treatment of this opportunistic infection in endemic areas.
Area of Science:
- Mycology
- Infectious Diseases
- Immunology
Background:
- Penicillium marneffei is an opportunistic pathogen causing systemic mycosis.
- HIV infection is associated with an increased risk of P. marneffei infections.
Purpose of the Study:
- To describe the clinical presentation and diagnosis of P. marneffei infection in HIV-infected patients.
- To evaluate the effectiveness of early diagnostic methods and treatments for P. marneffei mycosis.
Main Methods:
- Retrospective analysis of 21 HIV-infected patients with P. marneffei mycosis.
- Microscopic examination of bone marrow aspirate and skin biopsy smears for diagnosis.
- Clinical data review including symptoms, treatment, and outcomes.
Main Results:
- Fever, cough, and skin lesions were common clinical manifestations.
- Microscopy of bone marrow and skin smears provided rapid presumptive diagnosis in 11 patients.
- Parenteral amphotericin B and oral itraconazole showed favorable initial treatment responses.
Conclusions:
- P. marneffei is a significant opportunistic pathogen in HIV-infected individuals.
- Microscopic examination is a valuable tool for early diagnosis of P. marneffei infection.
- This mycosis should be considered in the differential diagnosis of AIDS in endemic regions like Southeast Asia and China.