Penicillium marneffei infection in a lung transplant recipient

Abstract

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.

Epidemiology of invasive fungal infections in lung transplant recipients in Western Australia

“…Note is made of an infection with the dimorphic fungus T. marneffei which is endemic in South‐East Asia and causes opportunistic infection. Many T. marneffei infections in organ transplant recipients are related to travel to an endemic area, as occurred in the case reported here which was previously described in more detail …”

Preliminary Study of Fourteen AIDS-Associated Lung Complications from Imaging,Pathology and Microbiology

“…Multiple nodules with a high density are fund in the lungs by CT view. In addition, various sizes holes sited in lower part of right lung with heterogeneous wall thickness and smooth inner wall are also observed [13,24]. Branched mycelum and clusters of small spores with typical broom-shaped sticks are detected under microscope view.…”

The in vitro fungicidal activity of human macrophages against Penicillium marneffei is suppressed by dexamethasone

“…Although most cases have been reported in HIV infection, a widespread increase in the use of potent immunosuppressive agents, as well as in the number of immunocompromised patients traveling to endemic areas, can be expected to increase the burden of disease in the future, particularly among transplant patients [8,9]. Glucocorticoids (GCs) have been widely used as immunosuppressive agents for the treatment of inflammatory disorders and autoimmune diseases [10], as well as solid organ and stem cell transplantation [11].…”