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Infection due to Penicillium marneffei, an emerging pathogen: review of 155 reported cases
1Department of Medical Microbiology and Immunology, University of Wisconsin, Madison, USA.
Abstract:
A disseminated and progressive infection, penicilliosis marneffei is the third most common opportunistic infection in human immunodeficiency virus (HIV)-infected patients in certain parts of Southeast Asia. Penicillium marneffei is endemic in Southeast Asia and the southern part of China. Cases have been reported from both Eastern and Western countries. This review discusses the history, epidemiology, mycology, clinical manifestations, diagnosis, and treatment of penicilliosis marneffei, on the basis of 155 cases of the infection. About 80% of the patients are immunocompromised. P. marneffei can infect various organs, particularly the lung, liver, and skin. The most common clinical features include fever, weight loss, and anemia. The organism has been isolated most commonly from skin, blood, and bone marrow. Immunologic identification of fungal isolates can be done with exoantigen tests and immunohistochemical methods. Treatment of disseminated penicilliosis marneffei in HIV-infected patients with parenteral amphotericin B and itraconazole is relatively effective and safe.
Insights
Penicilliosis marneffei is a serious fungal infection common in HIV patients in Southeast Asia. Treatment with amphotericin B and itraconazole is effective for this opportunistic infection.
Area of Science:
- Mycology
- Infectious Diseases
- Immunology
Background:
- Penicilliosis marneffei is a significant opportunistic infection in human immunodeficiency virus (HIV)-infected individuals, particularly in Southeast Asia.
- The fungus Penicillium marneffei is endemic to Southeast Asia and southern China, with cases reported globally.
- Approximately 80% of patients diagnosed with penicilliosis marneffei are immunocompromised.
Purpose of the Study:
- To provide a comprehensive review of penicilliosis marneffei, covering its history, epidemiology, mycology, clinical presentation, diagnosis, and treatment.
- To synthesize findings from 155 reported cases of Penicillium marneffei infection.
- To inform clinicians and researchers about this emerging infectious disease.
Main Methods:
- Literature review of 155 cases of penicilliosis marneffei.
- Analysis of epidemiological data, clinical manifestations, and diagnostic methods.
- Evaluation of treatment outcomes for Penicillium marneffei infections.
Main Results:
- Penicilliosis marneffei commonly affects immunocompromised individuals, particularly those with HIV.
- The infection can disseminate to multiple organs, with lungs, liver, and skin frequently involved.
- Common clinical signs include fever, weight loss, anemia, and isolation of the organism from skin, blood, and bone marrow.
Conclusions:
- Immunologic identification using exoantigen tests and immunohistochemistry aids in diagnosing Penicillium marneffei.
- Parenteral amphotericin B followed by itraconazole demonstrates relative safety and effectiveness in treating disseminated penicilliosis marneffei in HIV-infected patients.