Penicillium marneffei chylous ascites in acquired immune deficiency syndrome: a case report.
Penicillium marneffei (P. marneffei) infection usually occurs with skin, bone marrow, lung or hepatic involvement. However, no cases of P. marneffei infection with chylous ascites have been reported thus far. In this report, we describe the first case of acquired immune deficiency syndrome (AIDS) which has been complicated by a P. marneffei infection causing chylous ascites. We describe the details of the case, with an emphasis on treatment regimen. This patient was treated with amphotericin B for 3 mo, while receiving concomitant therapy with an efavirenz-containing antiretroviral regimen, but cultures in ascitic fluid were persistently positive for P. marneffei. The infection resolved after treatment with high-dose voriconazole (400 mg every 12 h) for 3 mo. P. marneffei should be considered in the differential diagnosis of chylous ascites in human immunodeficiency virus patients. High-dose voriconazole is an effective, well-tolerated and convenient option for the treatment of systemic infections with P. marneffei in AIDS patients on an efavirenz-containing antiretroviral regimen.
Department of Infectious Diseases, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China.
Yin-Zhong
YZ
Shen
Zhen-Yan
ZY
Wang
Hong-Zhou
HZ
Lu
D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis / Q000188:drug therapy; D000163:Acquired Immunodeficiency Syndrome / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology*; D000480:Alkynes; D000666:Amphotericin B / Q000494:pharmacology; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D000935:Antifungal Agents / Q000494:pharmacology; D048588:Benzoxazines / Q000627:therapeutic use; D002915:Chylous Ascites / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology*; D003521:Cyclopropanes; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000188:drug therapy; D010407:Penicillium / Q000187:drug effects / Q000378:metabolism*; D011743:Pyrimidines / Q000494:pharmacology; D018805:Sepsis / Q000188:drug therapy; D014230:Triazoles / Q000494:pharmacology; D065819:Voriconazole
D000480:Alkynes; D044966:Anti-Retroviral Agents; D000935:Antifungal Agents; D048588:Benzoxazines; D003521:Cyclopropanes; D011743:Pyrimidines; D014230:Triazoles; D000666:Amphotericin B; C098320:efavirenz; D065819:Voriconazole