Cytological diagnosis of Penicillium marneffei infection.
OBJECTIVE
Penicillium marneffei is an emerging opportunistic pathogen. The goal of this study was to study its clinical and radiographic presentation, and the diagnostic value of a cytological study of penicilliosis.


METHODS
A total of 24 patients with penicilliosis were found by culture in an 8-year period. Thirteen patients had cytological examination, which were retrospectively reviewed to analyze the morphological characteristics of P. marneffei and diagnostic yields of different cytological specimens.


RESULTS
Twenty (83%) of the 24 patients (20 males) had human immunodeficiency virus (HIV) infection. In eight (40%) patients, penicilliosis was the initial manifestation of HIV infection. Penicilliosis was diagnosed in all patients antemortem from culture of blood or other body sites. One (4%) died. Six of 13 patients who had cytological study had intra- or extracellular yeast-like organisms with transverse septum found in fine needle aspirate, imprint or sputum cytology studies. The cytological diagnostic yields for P. marneffei from lung biopsy imprint smears, lung aspirates, neck lymph node aspirates and sputum were 2/2, 2/4, 2/2 and 2/4, respectively. The cytological diagnosis could be made immediately after aspiration, much quicker than diagnosis from cultures.


CONCLUSIONS
P. marneffei causes disseminated infection, and can be the initial manifestation in HIV-infected patients in Taiwan. Penicilliosis can be diagnosed rapidly with cytological study of lung biopsy imprint smears, lung aspirates, neck lymph node aspirates or sputum.
Jan
I-Shiow
IS
Department of Laboratory Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, 7 Chung-Shan South Road, Taipei, Taiwan.
Chung
Ping-Fung
PF
Wang
Jann-Yuan
JY
Weng
Ming-Hsiang
MH
Hung
Chien-Ching
CC
Lee
Li-Na
LN
D005260:Female; D015658:HIV Infections / Q000150:complications; D006801:Humans; D008297:Male; D009181:Mycoses / Q000175:diagnosis* / Q000382:microbiology; D009894:Opportunistic Infections / Q000175:diagnosis; D010407:Penicillium / Q000166:cytology*