Disseminated Penicilliosis in a Korean Human Immunodeficiency Virus Infected Patient from Laos.
10.3346/jkms.2012.27.6.697
- Author:
Ja Young JUNG
1
;
Gi Ho JO
;
Hee Sung KIM
;
Mi Youn PARK
;
Jong Hee SHIN
;
Bum Sik CHIN
;
Ji Hwan BANG
;
Hyoung Shik SHIN
Author Information
1. Division of Infectious Disease, Department of Internal Medicine, National Medical Center, Seoul, Korea. moberrer@hanmail.net
- Publication Type:Case Reports
- Keywords:
Penicillium marneffei;
HIV/AIDS;
Korean;
Disseminated Infection
- MeSH:
Adult;
Amphotericin B/therapeutic use;
Anti-HIV Agents/therapeutic use;
Antifungal Agents/therapeutic use;
Bronchoscopy;
Dermatomycoses/drug therapy/microbiology/pathology;
HIV Infections/*diagnosis/drug therapy;
Humans;
Immunocompromised Host;
Laos;
Lung Diseases/drug therapy/*microbiology;
Male;
Penicillium/genetics/*isolation & purification;
Pneumocystis jirovecii/isolation & purification;
Tomography, X-Ray Computed
- From:Journal of Korean Medical Science
2012;27(6):697-700
- CountryRepublic of Korea
- Language:English
-
Abstract:
Penicillium marneffei may cause life-threatening systemic fungal infection in immune-compromised patients and it is endemic in Southeast Asia. A 39-yr-old HIV-infected male, living in Laos, presented with fever, cough, and facial vesiculopapular lesions, which had been apparent for two weeks. CT scans showed bilateral micronodules on both lungs; Pneumocystis jirovecii was identified by bronchoscopic biopsy. Despite trimethoprim-sulfamethoxazole and anti-tuberculosis medications, the lung lesions progressed and the facial lesions revealed central umbilications. Biopsy of the skin lesions confirmed disseminated penicilliosis, with the culture showing P. marneffei hyphae and spores. The P. marneffei was identified by rRNA PCR. A review of the bronchoscopic biopsy indicated penicilliosis. The patient completely recovered after being prescribed amphotericin-B and receiving antiretroviral therapy. This is the first case of penicilliosis in a Korean HIV-infected patient. It is necessary to consider P. marneffei when immunocompromised patients, with a history of visits to endemic areas, reveal respiratory disease.
