Acute abdomen: an unusual presentation of disseminated Penicillium marneffei infection.
Varied clinical presentations of Penicillium marneffei, an opportunistic pathogen in HIV disease has been rarely described in literature. We report a patient with advanced AIDS who presented to us with prolonged fever and had features of an acute abdomen. On radiologic imaging he had features of intestinal obstruction and mesenteric lymphadenitis. A diagnosis was made possible by endoscopic biopsies of the small bowel and bone marrow culture which grew P. Marneffei. He was treated with intravenous amphotericin for 2 weeks followed by oral itraconazole. This case is reported for its rarity and unusual presentation and to sensitise clinicians and microbiologists to consider this as an aetiology in patients with advanced HIV/AIDS who present with acute abdomen, more so in patients from a distinct geographic region--South-East Asia.
George
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IA
Department of Medicine, Christian Medical College and Hospital, Vellore-632 004, Tamil Nadu, India. igepreeta@cmcvellore.ac.in
Sudarsanam
T D
TD
Pulimood
A B
AB
Mathews
M S
MS
D000006:Abdomen, Acute / Q000209:etiology*; D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D000328:Adult; D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D001706:Biopsy; D001853:Bone Marrow / Q000382:microbiology; D006801:Humans; D007421:Intestine, Small / Q000382:microbiology; D017964:Itraconazole / Q000627:therapeutic use; D008297:Male; D009181:Mycoses / Q000175:diagnosis* / Q000188:drug therapy; D010407:Penicillium / Q000302:isolation & purification*; D011860:Radiography, Abdominal; D014057:Tomography, X-Ray Computed
D000935:Antifungal Agents; D017964:Itraconazole; D000666:Amphotericin B