title: Penicillium pneumonia in a patient with newly diagnosed Franklin disease.
abstract: Franklin disease, or gamma heavy-chain disease, in patients with autoimmune disorders is a challenge for clinicians to diagnose due to its rarity, and recurrent infection is one of its characteristics. Within the spectrum of infections in Franklin disease patients, various fungi should always be considered. In this study, the authors describe a 57-year-old non-human immunodeficiency virus-infected systemic lupus erythematosus patient later diagnosed with Franklin disease and then developed Penicillium pneumonia. Because of the unexpected combination of Franklin disease and Penicillium infection in a non-human immunodeficiency virus-infected patient, the diagnosis of common hospital-acquired pneumonia was initially made. The laboratory examinations and cultures helped confirm the correct diagnosis of Franklin disease and Penicillium pneumonia. This is the first report of Penicillium sp. infection in a patient with Franklin disease, and it emphasizes the importance of proper preparation for biopsy, complete hematologic investigation, culture preparation and early antifungal coverage to improve the outcome.
authors.affiliation: Division of Hematology/Oncology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
authors.forename: Chien-Hsiang
authors.initials: CH
authors.lastname: Weng
authors.forename: Ren-Ching
authors.initials: RC
authors.lastname: Wang
authors.forename: Tsu-Yi
authors.initials: TY
authors.lastname: Hsieh
authors.forename: Che-An
authors.initials: CA
authors.lastname: Tsai
authors.forename: Tseng-Hsi
authors.initials: TH
authors.lastname: Lin
mesh_terms: D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D003937:Diagnosis, Differential; D005260:Female; D006362:Heavy Chain Disease / Q000175:diagnosis* / Q000276:immunology; D006801:Humans; D008172:Lung Diseases, Fungal / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D008180:Lupus Erythematosus, Systemic / Q000276:immunology; D008875:Middle Aged; D010407:Penicillium / Q000302:isolation & purification*; D011014:Pneumonia / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D013624:Taiwan; D016896:Treatment Outcome
chemical_list: D000935:Antifungal Agents; D000666:Amphotericin B