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Acute Abdomen Due to Penicillium marneffei: An Indicator of HIV Infection in Manipur State

Hemanth Sureshwara Ghalige1, Biswajeet Sahoo2, Sanjeeb Sharma2

  • 1Junior Resident, Department of Surgery, RIMS , Imphal, India .

Journal of Clinical and Diagnostic Research : JCDR
|November 12, 2014
PubMed

Insights

Penicilliosis marneffei (PM) infection can mimic acute abdomen in undiagnosed advanced AIDS patients. Early diagnosis via lymph node cytology is crucial for timely treatment with antifungals.

Area of Science:

  • Medical Mycology
  • Infectious Diseases
  • Clinical Microbiology

Background:

  • Opportunistic infections in Human Immunodeficiency Virus (HIV) disease frequently present atypically, challenging clinical diagnosis.
  • Penicilliosis marneffei (PM) is a significant opportunistic infection, particularly in endemic regions.

Observation:

  • A case of advanced Acquired Immunodeficiency Syndrome (AIDS) with undiagnosed HIV presented with acute abdomen, characterized by prolonged fever and diffuse abdominal pain.
  • Radiological imaging revealed non-specific mesenteric and retroperitoneal lymphadenopathy.
  • Fine needle aspiration cytology (FNAC) of an enlarged lymph node was performed.

Findings:

  • Microscopic examination, Gram staining, and Sabouraud's dextrose agar (SDA) culture of the lymph node aspirate confirmed the presence of Penicillium marneffei.
  • The patient was successfully treated with intravenous amphotericin B.

Implications:

  • This case highlights the importance of considering PM in the differential diagnosis of acute abdomen, especially in individuals with risk factors or from endemic areas like Northeast India.
  • Clinicians and microbiologists should maintain a high index of suspicion for PM in patients presenting with unusual symptoms and undiagnosed HIV.
  • Prompt microbiological diagnosis is essential for initiating appropriate antifungal therapy and improving patient outcomes.
Keywords:
Acute abdomenHIVMesenteric lymphadenopathyPenicillium marneffei

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