Disseminated penicilliosis in a Korean human immunodeficiency virus infected patient from Laos.
Penicillium marneffei may cause life-threatening systemic fungal infection in immune-compromised patients and it is endemic in Southeast Asia. A 39-yr-old HIV-infected male, living in Laos, presented with fever, cough, and facial vesiculopapular lesions, which had been apparent for two weeks. CT scans showed bilateral micronodules on both lungs; Pneumocystis jirovecii was identified by bronchoscopic biopsy. Despite trimethoprim-sulfamethoxazole and anti-tuberculosis medications, the lung lesions progressed and the facial lesions revealed central umbilications. Biopsy of the skin lesions confirmed disseminated penicilliosis, with the culture showing P. marneffei hyphae and spores. The P. marneffei was identified by rRNA PCR. A review of the bronchoscopic biopsy indicated penicilliosis. The patient completely recovered after being prescribed amphotericin-B and receiving antiretroviral therapy. This is the first case of penicilliosis in a Korean HIV-infected patient. It is necessary to consider P. marneffei when immunocompromised patients, with a history of visits to endemic areas, reveal respiratory disease.
Division of Infectious Disease, Department of Internal Medicine, National Medical Center, Seoul, Korea.
Ja Young
JY
Jung
Gi Ho
GH
Jo
Hee-Sung
HS
Kim
Mi Youn
MY
Park
Jong Hee
JH
Shin
Bum Sik
BS
Chin
Ji Hwan
JH
Bang
Hyoung-Shik
HS
Shin
D000328:Adult; D000666:Amphotericin B / Q000627:therapeutic use; D019380:Anti-HIV Agents / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D001999:Bronchoscopy; D003881:Dermatomycoses / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology; D015658:HIV Infections / Q000175:diagnosis* / Q000188:drug therapy; D006801:Humans; D016867:Immunocompromised Host; D007812:Laos; D008171:Lung Diseases / Q000188:drug therapy / Q000382:microbiology*; D008297:Male; D010407:Penicillium / Q000235:genetics / Q000302:isolation & purification*; D045363:Pneumocystis carinii / Q000302:isolation & purification; D014057:Tomography, X-Ray Computed
D019380:Anti-HIV Agents; D000935:Antifungal Agents; D000666:Amphotericin B