Penicillium marneffeiInfection in AIDS

Abstract

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.

Appearances in dermatopathology: The diagnostic and the deceptive

“…Penicilliosis is a systemic fungal infection caused by a dimorphic fungus, Penicillium marneffei, common in HIV patients whose CD4 count is less than 50/mm, 3 and was first isolated from bamboo rats in Vietnam. [39] Fungal culture shows grey-white colonies surrounded by diffusible red pigment, and lactophenol cotton blue stain preparation of the culture specimen shows brush-like clusters of septate hyphae with terminal conidiospores. [40] PALISADING APPEARANCE Palisade means a wall or fence made from either wooden stakes or iron plates, and is built to defend a structure.…”

Skin and subcutaneous infections in south-east Asia

“…Penicilliosis is endemic in countries such as Malaysia, Thailand, Vietnam, Cambodia, southern China and India [30] most likely due to the humidity, which is an important factor in P. marneffei infection [31 to soil, particularly in the rainy seasons, have been identified as a significant risk factor for disseminated penicilliosis [32] and this suggests the soil as the main reservoir for the organism. Isolation of P. marneffei in organs of bamboo rats which rarely come in contact with humans also supported that both humans and rats may have acquired the infection from a common environmental source such as the soil [33,34].…”

“…Isolation of P. marneffei from tissue culture is the gold standard for diagnosis [30]. Preliminary diagnosis can be made in the presence of classic cutaneous lesions and visualization of the organism in the skin biopsy using Gomori-methenamine silver or Wright's stain.…”

Talaromyces marneffeilaccase modifies THP-1 macrophage responses

“…[1][2][3] T. marneffei has emerged as an opportunistic fungal pathogen associated with HIV infection in Northern Thailand, where penicilliosis is the third most common AIDS-associated disease, after tuberculosis and cryptococcosis. 4 Although the majority of T. marneffei infections in immunocompromised hosts have been found in HIV-infected patients, the incidence of penicilliosis marneffei has recently increased among non-HIV patients with other underlying diseases such as diabetes, cancer or systemic lupus erythematosus as putative susceptibility conditions.…”