Acute abdomen: An unusual presentation of disseminated &lt;i&gt; Penicillium marneffei&lt;/i&gt; infection

George, IA; Sudarsanam, TD; Pulimood, AB; Mathews,

doi:10.4103/0255-0857.40538

Cited by 16 publications

(10 citation statements)

References 6 publications

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“…Diarrhea was reported in 15–31% of patients in 3 large case series , while presentation with an acute abdomen has been described in a case from India . Intestinal penicilliosis can cause mucosal ulceration with mononuclear cell infiltrates containing the septate yeast form .…”

Section: Discussionmentioning

confidence: 99%

Penicillium marneffei infection in a lung transplant recipient

Stathakis

Lim

Boan

et al. 2015

Transplant Infectious Dis

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Penicillium marneffei is a thermally dimorphic fungus that can cause severe opportunistic infections in endemic regions of Southeast Asia, particularly in individuals infected with human immunodeficiency virus-1, but has rarely been reported in solid organ transplant recipients. Herein, we report the first case, to our knowledge, of P. marneffei infection in a lung transplant recipient, occurring in a 41-year-old woman 28 months post lung transplantation, after recent travel to Vietnam. We have reviewed the literature to derive some management principles for this rare infection in this clinical context. The number of P. marneffei infections in transplant recipients may increase, as a result of increasing rates of transplantation and travel to endemic areas.

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Section: Discussionmentioning

confidence: 99%

Penicillium marneffei infection in a lung transplant recipient

Stathakis

Lim

Boan

et al. 2015

Transplant Infectious Dis

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“…Diarrhoea is not uncommon and sometimes may be bloody. The infection may rarely present as acute abdomen [45, 46]. Other presenting symptoms include osteoarthritis, genital ulcers and oral lesions [16, 47–51].…”

Section: Clinical Featurementioning

confidence: 99%

Penicillium marneffeiInfection in AIDS

Wong

2011

Pathology Research International

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Penicillium marneffei is a dimorphic fungus which is endemic in Southeast Asia. It is an opportunistic pathogen which has emerged to become an AIDS-defining illness in the endemic areas. Early diagnosis with prompt initiation of treatment is crucial for its management. Prompt diagnosis can often be established through careful cytological and histological examination of clinical specimens although microbiological culture remains the gold standard for its diagnosis. Standard antifungal treatment for AIDS patients with penicilliosis is well established. Highly active antiretroviral therapy should be started early together with the antifungal treatment. Special attention should be paid to potential drug interaction between antiretroviral and antifungal treatments. Secondary prophylaxis may be discontinued with a low risk of relapse of the infection once the immune dysfunction has improved.

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“…The infection may rarely present as acute abdomen [5]. In patients with advanced HIV/AIDS who present with acute abdomen, opportunistic fungal infections of the bowel especially penicilliosis needs to be considered as aetiology, more so in patients from a distinct geographic region such as South-East Asia [6]. Authors have previously isolated four cases of disseminated P. marneffei in patients who were already suffering from HIV infection from the state of Manipur [1].…”

Section: Discussionmentioning

confidence: 99%

Acute Abdomen Due to Penicillium marneffei : An Indicator of HIV Infection in Manipur State

Ghalige

Sahoo

Sharma

et al. 2014

JCDR

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A-28-year-old male military personnel presented with a four day history of right sided non-colicky abdominal pain radiating to the back, and associated with fever and rigor for two weeks, at Regional Institute of Medical Sciences (RIMS), Imphal, Manipur, India. The fever used to subside only on medication. He had no other gastrointestinal or urinary symptoms. He was not an intravenous drug abuser but consumed alcohol in moderate amounts regularly. There was history of significant weight loss in the recent past.On general examination, he was pyrexic with associated tachycardia. Other than pallor and non tender non matted multiple lymphadenopathy no other significant finding was present.Abdomen was diffusely tender with mild guarding and could be palpated properly only after administering analgesics (Inj. Diclofenac 75 mg i.m.). Multiple lumps were palpated in all the quadrants. The lumps were firm in consistency, tender and mobile. Liver was just palpable.Chest radiograph looked normal. His blood test showed neutrophilia (20×10 9 /l), a raised ESR of 120 and a raised C-reactive protein of 200 mg/l. The rest of the blood tests including serum amylase were in the normal range.An abdominal radiograph was non-contributory and computed tomography of the abdomen multiple enlarged mesentric lymph nodes [Table/ Fig-1]. Patient was treated conservatively and started on broad spectrum intravenous antibiotics (ceftriaxone and ofloxacin) but his condition did not improve. Cultures of blood and lymph node aspirate showed growth on 3 rd day itself which were consistent with culture characteristics of Penicillium marneffei [Table/ Fig-3].Peri oral umbilicated lesions [Table/ Fig-4] appeared in the 4 th day during the course of antifungal treatment which further described the Penicillium dissemination. Treatment was started with Amphotericin B at the dose of 0.6 mg/kg/day intravenously for two weeks followed by Anti Retroviral Therapy and itraconazole as per recommendation. The patient showed marked improvement on follow up after six months and was symptom free with CD4 cell count of 350/mm 3 . DiSCuSSiOnPenicilliosis marneffei (PM) is a disseminated and progressive fungal infection caused by Penicillium marneffei, a facultative intracellular pathogen and the only dimorphic species of the genus Penicillium ABSTRACTOpportunistic infection in HIV disease often present to clinicians in an atypical manner testing clinical acumen. Here, we report a case of Penicilliosis marneffei (PM) infection presenting to surgical emergency as acute abdomen with undiagnosed HIV status in advanced AIDS, chief complaints being prolonged fever and diffuse abdominal pain. Radiologic imaging showed non-specific mesenteric and retroperitoneal lymphadenopathy. Fine needle aspiration cytology (FNAC) of the lymph node was done and subjected to direct microscopy, gram staining and culture on Sabouraud's dextrose agar (SDA) which showed Penicillium marneffei. He was then treated with intravenous amphotericin. This case is reported for its rarity and unusual...

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Acute abdomen: An unusual presentation of disseminated <i> Penicillium marneffei</i> infection

Cited by 16 publications

References 6 publications

Penicillium marneffei infection in a lung transplant recipient

Penicillium marneffei infection in a lung transplant recipient

Penicillium marneffeiInfection in AIDS

Acute Abdomen Due to Penicillium marneffei : An Indicator of HIV Infection in Manipur State

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