title: Penicillium piceum infection: diagnosis and successful treatment in chronic granulomatous disease.
abstract: Infections due to Penicillium species other than P.marneffei are rare. We identified a boy with X-linked chronic granulomatous disease (X-CGD) with a pulmonary nodule and adjacent rib osteomyelitis caused by Penicillium piceum. The only sign of infection was an elevated sedimentation rate. P. piceum was isolated by fine needle aspirate and from excised infected tissues. Surgical removal and one year of voriconazole treatment were very well tolerated and led to complete recovery. Microbiological, microscopic and molecular studies support the fungal diagnosis. P. piceum should be considered as a relevant pathogen in immunocompromised patients.
authors.affiliation: Laboratorio de Microbiología, Hospital de Pediatría J. P. Garrahan, Buenos Aires, Argentina.
authors.forename: P E
authors.initials: PE
authors.lastname: Santos
authors.forename: E
authors.initials: E
authors.lastname: Piontelli
authors.forename: Y R
authors.initials: YR
authors.lastname: Shea
authors.forename: M L
authors.initials: ML
authors.lastname: Galluzzo
authors.forename: S M
authors.initials: SM
authors.lastname: Holland
authors.forename: M E
authors.initials: ME
authors.lastname: Zelazko
authors.forename: S D
authors.initials: SD
authors.lastname: Rosenzweig
mesh_terms: D000935:Antifungal Agents / Q000627:therapeutic use; D044963:Biopsy, Fine-Needle; D001799:Blood Sedimentation; D002648:Child; D004271:DNA, Fungal / Q000737:chemistry / Q000235:genetics; D040181:Genetic Diseases, X-Linked / Q000150:complications*; D006105:Granulomatous Disease, Chronic / Q000150:complications*; D006801:Humans; D008297:Male; D008853:Microscopy; D008969:Molecular Sequence Data; D009181:Mycoses / Q000175:diagnosis* / Q000188:drug therapy* / Q000382:microbiology; D010019:Osteomyelitis / Q000188:drug therapy* / Q000382:microbiology*; D010407:Penicillium / Q000302:isolation & purification*; D011743:Pyrimidines / Q000627:therapeutic use; D013902:Radiography, Thoracic; D017422:Sequence Analysis, DNA; D014230:Triazoles / Q000627:therapeutic use; D065819:Voriconazole
chemical_list: D000935:Antifungal Agents; D004271:DNA, Fungal; D011743:Pyrimidines; D014230:Triazoles; D065819:Voriconazole