Disseminated Penicillium marneffei infection with fungemia and endobronchial disease in an AIDS patient in China.
OBJECTIVE
To present a rare Chinese case of disseminated Penicillium marneffei infection with fungemia and endobronchial disease in an AIDS patient.


METHODS
A 26-year-old policeman who had resided in Guangxi Province, China, for 3 years presented to his county hospital with a 2-month history of high fever and cough. A provisional diagnosis of pulmonary tuberculosis (TB) was made. Accordingly, the patient was treated with anti-TB drugs for 1 month but with no clinical improvement; he was then referred to West China Hospital. Blood and bone marrow cultures as well as a bronchoscopic biopsy were positive for P. marneffei. A confirmatory serologic test for HIV was positive. A combination therapy with amphotericin B and itraconazole was instituted, and the patient responded well to treatment.


CONCLUSIONS
This case shows endobronchial involvement caused by an emerging fungal microorganism. HIV-positive patients with a history of residence in or travel to southern China and a clinical presentation suggestive of TB but responding poorly to anti-TB treatment may have P. marneffei infection.
Zhiyong
Zong
Z
Department of Infectious Diseases, West China Hospital, Sichuan University, People's Republic of China. mishle333@yahoo.com
Mei
Kang
K
Yanbin
Liu
L
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D000328:Adult; D001982:Bronchial Diseases / Q000150:complications / Q000175:diagnosis* / Q000382:microbiology*; D002681:China; D016469:Fungemia / Q000150:complications / Q000175:diagnosis* / Q000382:microbiology*; D006801:Humans; D008297:Male; D010407:Penicillium