Penicillium marneffei Infection: An Emerging Disease in Mainland China

Hu, Yongxuan; Zhang, Junmin; Li, Xiqing; Yang, Yu-Chih; Zhang, Yong; Ma, Jiyong; Xi, Liyan

doi:10.1007/s11046-012-9577-0

Cited by 233 publications

(218 citation statements)

References 22 publications

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“…Our results show that TRB and the echinocandins are highly active in vitro against Penicillium and Talaromyces spp. However, these antifungals are not widely used for treating invasive infections by these fungi (41). Terbinafine was chosen as a good alternative for long-term maintenance therapy for treatment of an infection associated with one isolate from a dog with osteomyelitis (11).…”

Section: Discussionmentioning

confidence: 99%

Identification and Antifungal Susceptibility of Penicillium-Like Fungi from Clinical Samples in the United States

et al. 2016

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bPenicillium species are some of the most common fungi observed worldwide and have an important economic impact as well as being occasional agents of human and animal mycoses. A total of 118 isolates thought to belong to the genus Penicillium based on morphological features were obtained from the Fungus Testing Laboratory at the University of Texas Health Science Center in San Antonio (United States). The isolates were studied phenotypically using standard growth conditions. Molecular identification was made using two genetic markers, the internal transcribed spacer (ITS) and a fragment of the ␤-tubulin gene. In order to assess phylogenetic relationships, maximum likelihood and Bayesian inference assessments were used. Antifungal susceptibility testing was performed according to CLSI document M38-A2 for nine antifungal drugs. The isolates were identified within three genera, i.e., Penicillium, Talaromyces, and Rasamsonia. The most frequent species in our study were Penicillium rubens, P. citrinum, and Talaromyces amestolkiae. The potent in vitro activity of amphotericin B (AMB) and terbinafine (TRB) and of the echinocandins against Penicillium and Talaromyces species might offer a good therapeutic alternative for the treatment of infections caused by these fungi.

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Section: Discussionmentioning

confidence: 99%

Identification and Antifungal Susceptibility of Penicillium-Like Fungi from Clinical Samples in the United States

et al. 2016

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“…During the past few years, the incidence of penicilliosis infection has markedly increased, paralleling the incidence of human immunodeficiency virus infection. In China, the endemic of P. marneffei infection in South China, particularly in Guangdong, Guangxi, Yunnan and other regions (6). The source of infection is most likely decaying vegetative material or soil from natural habitat.…”

Section: Discussionmentioning

confidence: 99%

Disseminated Penicillium marneffei infection recurrence in a non-acquired immune deficiency syndrome patient: A case report

Zhang¹,

Tao²,

Li³

et al. 2016

Molecular and Clinical Oncology

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Abstract. Penicillium marneffei is a rare deep tissue fungal infection causing an endemic in Southeast Asia. This infection causes penicilliosis disease and is more common in patients who are immunocompromised. To date, no cases of P. marneffei infection relapse following treatment have been reported. A 36-year-old patient attended our hospital as a result of intermittent fever, cough, shortness of breath and multiple soft lesions located on the face, arms, neck and trunk. The medical radiological examination of the lung revealed multiple patchy exudative shadows, thick-walled hollow inner part of the visible lesions, bilateral pleural and pericardial effusion. Assessing the skull and right collarbone, bilateral thoracic ribs and a plurality revealed numeorus lesions with reduced bone destruction and revealed that the patient was positive for P. marneffei infection. After 6 months of antifungal therapy, pulmonary symptoms and the surface lesions of the patient rapidly disappearance and the physical condition markedly improved. The patient did not attend a follow-up and stopped antifungal treatment. In February 2016, the patient presented with left breast and subcutaneous soft tissue mass of the head and neck. Fungal culture results revealed that the patient was again positive for P. marneffei infection. The present case suggested that clinical doctors and patients must pay more attention to regular treatment of the disseminated P. marneffei. It also highlighted the requirement for awareness of penicilliosis in non-acquired immune deficiency syndrome patients, who are not immunocompromised, who are living in or traveling to P. marneffei-endemic areas.

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“…However, sporadic cases of penicilliosis has been observed in immunocompromised individuals from non-endemic countries such as the Unites States, Japan, Korea and Germany, who have traveled to the endemic areas[2–5]. In mainland China, penicilliosis is endemic in the southern provinces such as Guangxi, Guangdong, Fujian, Yunnan, Hunan, and Hong Kong[6, 7], but there have been no case reports of penicilliosis from other regions of China.…”

Section: Introductionmentioning

confidence: 99%

A Clinical Study of Acquired Immunodeficiency Syndrome Associated Penicillium Marneffei Infection from a Non-Endemic Area in China

et al. 2015

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ObjectiveTo investigate the clinical characteristics, diagnosis, treatment and prognosis of penicilliosis among the patients with acquired immunodeficiency syndrome (AIDS) in non-endemic areas of China, and then to discuss its incubation period and the diagnostic performance of serum galactomannan test for penicilliosis.MethodsMedical records and travel histories of penicilliosis patients in Zhongnan hospital from January 2006 to December 2013, and the interval from when the patients left the endemic area to the onset of the disease was analyzed. Serum galactomannan levels of penicilliosis patients and AIDS patients with fever were measured by the Platelia Aspergillus Enzyme Immunoassay Kit.ResultsA total of 47 AIDS-associated penicilliosis were confirmed by fungal culture, which accounted for 4.8% of 981 AIDS-related admissions. The sensitivity and specificity of serum galactomannan test for penicilliosis were 95.8% (23/24) and 90.9% (30/33), respectively, (cutoff index = 1.0). Two independent predictors for early mortality (death within 12 weeks) of the patients (21.3%, 10/47) were a delayed diagnosis and no treatment with antifungal therapy. Among 14 patients who became ill after leaving endemic areas, ten patients presented with the onset symptoms within 12 months (from 11 days to 360 days). We found a patient living with asymptomatic P. marneffei fungemia who had not received any antifungal therapy until 18 months’ follow up.ConclusionsThe co-infection of P. marneffei and HIV was not uncommon in the non-endemic areas of penicilliosis in China. There exists a latent form of infection for P. marneffei. The incubation period of penicilliosis may be quite different from one patient to another. In AIDS patients, the serum galactomannan test has utility for the diagnosis of penicilliosis. When patients with penicilliosis/AIDS were diagnosed early and treated with standardized antifungal therapy and combined antiretroviral therapy, their prognosis improved.

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Penicillium marneffei Infection: An Emerging Disease in Mainland China

Cited by 233 publications

References 22 publications

Identification and Antifungal Susceptibility of Penicillium-Like Fungi from Clinical Samples in the United States

Identification and Antifungal Susceptibility of Penicillium-Like Fungi from Clinical Samples in the United States

Disseminated Penicillium marneffei infection recurrence in a non-acquired immune deficiency syndrome patient: A case report

A Clinical Study of Acquired Immunodeficiency Syndrome Associated Penicillium Marneffei Infection from a Non-Endemic Area in China

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