The analysis of risk factors and the immune status in Penicillium marneffei in patients without human immunodeficiency virus infection

Abstract

Abstract:

Objective To analyze the risk factors and the immune status in Penicillium marneffei,for improving the clinical diagnosis.Methods A case admitted to Xiangya Hospital Central South University,diagnosed as Penicillium marneffei,was retrospectively analyzed and the related literature was reviewed.Databases including PubMed,Wanfang and Chinese National infrastructure (CNKI) were searched by using the keyword "Penicillium marneffei".Then the risk factors and possible immune mechanism were summarized.Results The patient,middle-age male,was a forest worker,presented with intermittent fever,cough,dyspnea,emaciation,and frequent enlargement of left supraclavicular and mediastinal lymph nodes.Although without any underlying disease,the patient was found to have a history of contact with wild animal.Imageology showed diffuse pulmonary lesions.G,GM test were dramatically accelerated,and HIV test was negative.Anti-tuberculosis treatment was invalid.Penicillium marneffei was proved by fungal culture from percutaneous lung biopsy tissue and pathological diagnosis.The syptoms and imageology of the patient,after 4months of sequential treatment of Amphotericin B and itraconazole,were relieved and improved.From databases above,91 cases of HIV-negative Penicillium marneffei were retrieved.Among the cases above,45 cases were reported with underlying diseases.Conclusions Penicillium marneffei,associated with the history of contacting with reservoir host,the life or journey in epidemic region,exposure to certain environment,climate and humidity,could happen in patients without HIV,while with underlying diseases,such as connective tissue diseases,hematological system disease,organ transplantation,and so on,or those happened with gene mutation,related to antimycotic immunity.Patiens,described as before,should be alerted for their possibility of diagnose as Penicillium marneffei. The sequential treatment of Amphotericin B to itraconazole turned out to be effective.

Key words: Penicillium marneffei, human immunodeficiency virus negative, immune status

CLC Number:

R519.8

XIE Ya-li, LI Yuan-yuan, HU Cheng-ping, DENG Peng-bo, LIU He-ping, WANG Qiong. The analysis of risk factors and the immune status in Penicillium marneffei in patients without human immunodeficiency virus infection[J]. Chinese Journal of Mycology, 2016, 11(3): 174-177.

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