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A 12-case series of Penicillium marneffei pneumonia

Athavudh Deesomchok1, Surat Tanprawate

  • 1Division of Pulmonary, Critical Care Medicine and Allergy, Department of Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand. adeesomc@mail.med.cmu.ac.th

Journal of the Medical Association of Thailand = Chotmaihet Thangphaet
|May 16, 2006
PubMed
Abstract

Insights

Penicillium marneffei pneumonia, often seen in HIV patients, presents with varied lung symptoms and signs. Early diagnosis is crucial due to potential co-infections and non-specific manifestations.

Area of Science:

  • Medical Mycology
  • Infectious Diseases
  • Pulmonology

Background:

  • Penicillium marneffei is an endemic fungus in Southeast Asia and southern China.
  • It causes opportunistic infections, particularly pulmonary disease, in HIV-infected individuals.
  • Pulmonary Penicillium marneffei infections are infrequently reported despite potential for significant morbidity.

Purpose of the Study:

  • To investigate the clinical features of Penicillium marneffei pneumonia.
  • To analyze diagnostic methods using sputum or bronchoalveolar lavage (BAL) cultures.
  • To understand the presentation in a specific patient cohort.

Main Methods:

  • A retrospective descriptive study was conducted.
  • Data were collected from patients diagnosed between September 1999 and July 2004.
  • Diagnostic confirmation relied on microbial cultures of respiratory specimens.

Main Results:

  • Twelve patients were identified, with nine being HIV-infected.
  • Common symptoms included fever, cough, dyspnea, and weight loss; extrapulmonary signs like skin lesions were noted.
  • Chest radiographs showed diverse patterns including reticulonodular, reticular, alveolar, and cavitary infiltrates.
  • Co-infections with bacteria, fungi, and parasites were frequently observed.
  • Treatment typically involved amphotericin B followed by itraconazole, or itraconazole alone.

Conclusions:

  • Penicillium marneffei pneumonia exhibits non-specific clinical manifestations, mimicking other infections.
  • The possibility of co-infections necessitates a broad differential diagnosis.
  • Clinicians should consider Penicillium marneffei pneumonia, especially in immunocompromised patients presenting with respiratory symptoms.

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