Penicilliosis

Penicilliosis
Classification and external resources
Specialty infectious disease
ICD-10 B48.4
ICD-9-CM 117.3
DiseasesDB 9802

Penicilliosis (or penicillosis) is an infection caused by Penicillium marneffei.[1]

It is a dimorphic fungus.[2][3]

Epidemiology

Once considered rare, its occurrence has increased due to AIDS. It is now the third most common opportunistic infection (after extrapulmonary tuberculosis and cryptococcosis) in HIV-positive individuals within the endemic area of Southeast Asia.

Diagnosis and symptoms

Diagnosis is usually made by identification of the fungi from clinical specimens. Biopsies of skin lesions, lymph nodes, and bone marrow demonstrate the presence of organisms on histopathology.

The most common symptoms are fever, skin lesions, anemia, generalized lymphadenopathy, and hepatomegaly.

Treatment and prognosis

Penicillium marneffei demonstrates in vitro susceptibility to multiple antifungal agents including ketoconazole, itraconazole,[4] miconazole, flucytosine, and amphotericin B. Without treatment patients have a poor prognosis; death occur by liver failure as the fungus releases toxins in the bloodstream. The elevation of liver enzyme in the blood helps to establish a diagnosis.

References

  1. Desakorn V, Smith MD, Walsh AL, et al. (January 1999). "Diagnosis of Penicillium marneffei infection by quantitation of urinary antigen by using an enzyme immunoassay". Journal of clinical microbiology. 37 (1): 117–21. PMC 84182Freely accessible. PMID 9854074.
  2. Pautler KB, Padhye AA, Ajello L (1984). "Imported penicilliosis marneffei in the United States: report of a second human infection". Sabouraudia. 22 (5): 433–8. doi:10.1080/00362178485380691. PMID 6505916.
  3. Sirisanthana T, Supparatpinyo K (1998). "Epidemiology and management of penicilliosis in human immunodeficiency virus-infected patients". Int. J. Infect. Dis. 3 (1): 48–53. doi:10.1016/S1201-9712(98)90095-9. PMID 9831676.
  4. Wu TC, Chan JW, Ng CK, Tsang DN, Lee MP, Li PC (April 2008). "Clinical presentations and outcomes of Penicillium marneffei infections: a series from 1994 to 2004". Hong Kong Med J. 14 (2): 103–9. PMID 18382016.
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