Abstract:

Penicillium marneffei (PM) infection is prevalent in South-East Asia and Southern China, which has been considered an acquired immunodeficiency syndrome (AIDS)-defining disease. In this paper, we describe Penicillium marneffei sepsis in an HIV-infected patient without skin presentation. A 39-year-old man from Guangdong province came to our clinic with 1-month history of fevers and lymphadenectasis. He was found continuously decrease of leukocyte, erythrocyte and thrombocyte. Anti-HIV antibody screening test and confirmation test both appeared positive. Blood cultures were positive for fungi. Bone marrow biopsy showed intracellular septate spores. The P.marneffei was identified by rDNA PCR. The patient was diagnosed with AIDS and Penicillium marneffei sepsis. He was treated immediately with fluconazole and transferred to the infectious disease hospital. During the follow-up, he died of multiple organ failure. This case suggests that fungemia could be the initial symptom of penicilliosis marneffei, which should be paid enough attention by clinicians. Patient's blood should be strictly isolated because of its infectivity, and detection of HIV antibody is necessary. The patients with fever of unknown origin and unsafe sex history may be diagnosed as infection of HIV and Penicillium marneffei.

Key words: Penicillium marneffei, sepsis, AIDS