The photographs of pneumocystis, penicillium marneffei, and paracoccidioides brasiliensis are reprinted from the cdc public health image library collection. Department of biological sciences and center for applied chemical biology youngstown. We trapped bamboo rats during june 2004july 2005 across guangxi province, china, and demonstrated 100% prevalence of infection. A case of penicillium marneffei osteomyelitis involving the.
Development of a pcrbased assay to detect penicillium marneffei in insects kristin latessa, jamielynndoyle, jason gilmore, sara johnson advisor. Penicilliosis is an infection caused by the fungus penicillium marneffei p. The disease is an important endemic opportunistic infection of patients with acquired immunodeficiency syndrome with involvement of lungs, lymph nodes, liver, kidney, skin, and bone. Treatment is with amphotericin b, followed by itraconazole to prevent relapse.
Talaromycosis previously referred to as penicilliosis was commonly diagnosed in hivinfected individuals from endemic areas prior to the era of potent antiretroviral therapy art, and was an important cause of morbidity and mortality. Pdf first cases of disseminated penicilliosis marneffei. The species penicillium marneffei belong to genus penicillium which has more than 250 known species, widely distributed in nature found in soil as well as decomposed organic debris. The liver biopsy showed epithelioid cell granulomas only, and tuberculosis was initially. Common reservoirs for penicillium marneffei infection in. Histopathology remains one of the major tools of diagnosis in mycology. Penicillium marneffei infection in a patient with sle. A unique characteristic of penicillium marneffei mould is the presence of a soluble red pigment that diffuses into the agar making the reverse side appear either pink or red at 25 c 2.
Penicillium marneffei is emerging as an important opportunistic. Penicillium marneffei infection in a hivpositive patient. The differential diagnosis includes other fungal infections, such as histoplasma capsulatum and. Pdf penicillium marneffei is an emerging opportunistic pathogen. Penicillium marneffei penicillium marneffei bioline international. A case of cutaneous penicilliosis in a child with acute myeloid. A patient who presented with autoimmune haemolytic anaemia and hepatosplenomegaly, and was subsequently found to be suffering from disseminated penicillium marneffei infection, is reported. Histopathological sections may be stained with hematoxylin and eosin, grocott methenamine silver, or periodic acidschiff stai.
Introductionpenicillium marneffei is the only penicillium species that is a dimorphic fungus and can cause systemic mycosis in human beings. This study describes the use of single and nested pcr methods for the rapid identification of p. Cytological diagnosis of penicillium marneffei infection ishiow jan, 1pingfung chung, jannyuan wang,2 minghsiang weng, chienching hung,2 lina lee1,2 backgroundpurpose. Signature gene expression reveals novel clues to the. Penicillium marneffei, penicilliosis, leprosy, disseminated, antifungal introduction penicillium marneffeiinfection, generally referred to as penicilliosis is an aids defining disease with a mortality of 75% if left untreated. Prompt diagnosis can often be established through careful cytological and histological examination of clinical specimens. Systemic infection ofpenicillium marneffei has protean manifestations including fever, weight loss, anaemia, skin lesions, and lymphadenopathy.
Penicillium marneffei is a major cause of opportunistic infection in patients with aids in north and northeastern thailand. Hivinfected patients, but intestinal penicilliosis marneffei has rarely been. Penicillium marneffei infections youngstown state university. Case report disseminated penicillium marneffei infection with.
Differences in clinical characteristics and prognosis of. For the second method, the yeast form of penicillium marneffei was identified by cytology and histopathology. A pcrhybridization assay has been developed to identify this pathogen. At temperatures below 37c, the fungus grows as mycelia with the formation of septate hyphae, bearing conidiophores and conidia typical of the genus penicillium. Unusual disseminated talaromyces marneffei infection. The chest radiograph failed to show any obvious pathology. Development of a pcrbased assay to detect penicillium. Symptoms include fever, anemia, weight loss, and skin lesions.
Dermatology online journal, volume 16 number 7 july 2010. Penicillium marneffei is a type of dimorphic fungi. Talaromyces marneffei an overview sciencedirect topics. Rarely noted before the aids epidemic, p marneffei infections have become more prevalent in the endemic areas in conjunction with the aids epidemic. Hall c, hajjawi r, barlow g, thaker h, adams k, moss p.
The peak incidence occurred in the period from the year 1996 to 2000, which was about 10 years. For individuals with hiv, this systemic fungal infection was commonly diagnosed prior to the era of potent antiretroviral therapy art. Talaromyces marneffei formerly penicillium marneffei was considered the only pathogen in this group. Diagnostic criteria for psm with osteolytic lesion patients were diagnosed according to the following criteria. Penicillium marneffei infection and recent advances in the epidemiology and molecular biology. We describe a patient with sle who was infected by the fungus penicillium marneffei. Four sle patients with disseminated penicilliosis had been previously reported out of which 3 died. Talaromyces marneffei infection occurs mostly in people with weakened immune systems, such as people with hiv. Penicillium marneffei is a rare human pathogen that often causes problems in clinical and histological diagnosis.
Penicillium marneffei infection in patients infected with the human immunodeficiency virus. Histopathologic diagnosis of fungal infections in the 21st. It can cause systemic and deep seated infection in immunocompromised patients. The clinical manifestation includes high fever, chills, weight loss, general malaise. Penicillium marneffei is a rare human pathogen predominantly affecting residents of south. Disseminated infection with the fungus penicillium marneffei in human immunodeficiency virus. A case of penicillium marneffei osteomyelitis involving the axial skeleton ts pun, d fang fungal infection of bone by penicillium marneffei is rare.
Pdf penicillium marneffei infection in aids semantic scholar. Persons affected by penicilliosis usually have aids with low cd4 lymphocyte counts. Cutaneous penicilliosis due to penicillium marneffei. Nicholson dm frcpath, in pathology of the lungs third edition, 2011. An update on penicillium marneffei infection and advances in. It is an opportunistic pathogen which has emerged to become an aidsdefining illness in the endemic areas. Vanittanakom n, cooper r, fisher m, sirisanthana t, penicillium marneffei vanittanakom n, cooper r, fisher m, sirisanthana t, penicillium marneffei. Although it has been isolated from bamboo rats, the ecological niche in nature is unknown.
The differences may be due to the method adopted, which ranges. Penicillium marneffei infection in a patient with sle c. Cytological diagnosis of penicillium marneffei infection core. Penicillium marneffei is a rare invasive fungal infection that primarily occurs in the southeastern and east ern regions of asia in hivpositive individuals. Lymphadenopathy due to penicillium marneffei infection. She was initially misdiagnosed as having disseminated tuberculosis. May, 2020 penicillium marneffei talaromyces marneffei infection is an important cause of morbidity and mortality in hiv. Phylogeny and pcr identification of the human pathogenic. Talaromycosis formerly penicilliosis fungal diseases cdc. Penicillium marneffei is capable of causing disseminated infection in both humans and animals. Infections caused by penicillium marneffei in china and southeast asia.
Penicillium marneffei, a dimorphic fungus that is endemic in southeast asia. The major advantages of histopathology are speed, lowcost, and the ability to provide a presumptive identification of the infecting fungus, as well as demonstrating the tissue reaction. High prevalence of infection among bamboo rats of the genera rhizomys and cannomys suggest that these rodents are a key facet of the p. Dec 01, 2006 fungus is hyaline hyphomycetes, related to aspergillus university of adelaide. Penicillium marneffei infection in an aids patient. Penicillium marneffei causes serious disseminated disease with characteristic papular skin lesions in patients with aids in southeast asia. A simple nematode infection model for penicillium marneffei xiaowen huang1,2, dedong li1,3, liyan xi2, eleftherios mylonakis1 1division of infectious diseases, rhode island hospital, warren alpert medical school of brown university, providence, rhode island, united states of america. Talaromyces marneffei formerly penicillium marneffei causes a systemic fungal infection referred to as talaromycosis. Pdf penicillium marneffei infection in aids semantic. Supparatpinyo k, chiewchanvit s, hirunsri p, uthammachai c, nelson ke, sirisanthana t. Talaromyces penicillium marneffei is an important opportunistic fungal pathogen. Unusual pulmonary manifestations of disseminated penicillium. Adaptation to macrophage killing by talaromyces marneffei. The disease is endemic in south east asian countries.
Yuen wc, chan yf, loke sl, wh seto, gp poon, kk wong. Pdf histopathological and electron microscopical studies. It is a thermally dimorphic fungi that cause invasive mycosis in immunocompromised in endemic areas penicillium spp. Asymptomatic pulmonary penicilliosis with a lung mass in an. Histoplasmosis and penicilliosis are infections caused by the dimorphic fungi, histoplasma capsulatum and penicillium marneffei, respectively. Penicillium marneffei is a dimorphic fungus which is endemic in southeast asia. Human penicilliosis marneffei is an emerging infectious disease caused by the fungus penicillium marneffei. Successful treatment of aidsassociated talaromycosis with. Penicillium marneffei infection and recent advances in the. Penicillium marneffei is an opportunistic pathogen predominantly found in southeast asia. Penicillia figure among the most common types of fungi isolated form the environment. Segratain in paris only known thermally dimorphic species of penicillium can cause penicilliosis with fever and anemia dimorphic saprophyte of soil and decomposing organic matter. We describe a 46yearold chinese woman who had a 10 yea.
Penicillium marneffei is an emerging pathogenic fungus that can cause a lifethreatening systemic mycosis in immunocompromised hosts, especially in patients with aids. An emerging pathogenic dimorphic fungus, penicillium marneffei, is one of the major causes of morbidity in patients with human immunodeficiency virus infection in southeast asia. At 37uc, the fungus undergoes the phase transition with concomitant coupling of nuclear and. Signature gene expression reveals novel clues to the molecular mechanisms of dimorphic transition in penicillium marneffei ence yang1, wangngai chow2, gang wang1, patrick c. Penicillium marneffei was renamed talaromyces marneffei. Immunoassays based on penicillium marneffeimp1p derived. Pdf histopathological and electron microscopical studies on. Talaromyces marneffei major endemic mycosis of aids patients in southeast asia, china, hong kong and taiwan almost always systemic with fever, weight loss and anemia. Massive hepatosplenomegaly caused by penicillium marneffei. It is a particularly important cause of disease due to weakened immunity i.
The correct diagnosis was finally made by bone marrow culture and she responded to a prolonged course of amphotericin b, flucytosine and itraconazo. Talaromyces marneffei formerly penicillium marneffei is an important cause of morbidity and mortality in patients with aids, as well as other immunocompromised individuals who live in or are from southeast asia. Early diagnosis with prompt initiation of treatment is crucial for its management. Natural infections occur in bamboo rats and in humans living in or having travelled in indonesia or southest asian countries. We report on a case of penicillium marneffei infection in a filipino woman, which involved multiple softtissue abscesses and infection of the axial skeleton. Departments of internal medicine, laboratory medicine, and pathology. This method was evaluated with 33 patients with cultureproven. Penicilliosis due to penicillium marneffei has been increasingly. Recently, cases of penicillium marneffei infections in aids patients have been documented2. Chronic lymphadenopathy caused by penicillium marneffei.
Histopathological and mycological study of the skin. We report a rare case of penicillium colitis in an aids patient who responded successfully to a course of amphotericin b therapy. The fungus is dimorphic, forming yeastlike cells that are often intracellular, resembling histoplasmosis, in infected tissues. Invasive infection caused by penicillium marneffei. Penicillium marneffei infection presenting as oral ulcerations in a. Rapid identification of penicillium marneffei by pcrbased. Penicillium marneffei is the only known penicillium species that exhibits temperaturedependent dimorphic growth. The disease is an important endemic opportunistic infection of patients with acquired immunodeficiency syndrome with involvement of lungs, lymph nodes. It has been shown that in talaromyces marneffei penicillium marneffei, a pathogenic dimorphic fungus, the saka gene is involved, not only in tolerance against oxidative and heat stresses, but also in playing a role in asexual development, yeast cell generation in vitro and survival.
Penicillium marneffei is an important cause of morbidity and mortality in hiv infected and other. Penicillium marneffei an overview sciencedirect topics. Penicillium marneffei is an important opportunistic pathogen in southeast asia in hivpositive individuals, but it rarely infects nonhiv ones. Differential diagnoses of secondary syphilis, histoplasmosis, cryptococcosis and penicilliosis were considered. Central nervous system infection with other endemic mycoses. Dermatoscopy for the rapid diagnosis of talaromyces marneffei. Asymptomatic pulmonary penicilliosis with a lung mass in. Penicillium marneffei was renamed talaromyces marneffei in 2015, and the disease, which had been referred to as penicilliosis, is now called talaromycosis. Penicillium marneffei is an emerging pathogenic fungus that can cause systemic mycosis among human immunodeficiency virus infected patients. Penicillium marneffei is endemic in parts of southeastern asia. Penicilliosis is an infection caused by penicillium marneffei, a dimorphic fungus endemic to southeast asia and the southern part of china. Penicillium marneffei grows at 25 c as a mould typical of the genus, but is atypical by its ability to convert to a parasitic, yeastlike phase of growth at 37 c on the appropriate media in vitro or in infected animals and humans. Natural infections occur in bamboo rats and in humans living in or having travelled in indonesia or southest.
Pdf penicillium marneffei is a dimorphic fungus which is endemic in. Penicillium marneffei is a rare fungal pathogen which can cause humaninfections in people predominantly living in southeast asia and the southern portion of china. Penicillium marneffei is an emerging pathogenic fungus that can. Penicillium marneffei presenting as an immune reconstitution inflammatory syndrome in a patient with advanced hiv. Department of pathology, the first affiliated hospital, zhejiang. Role of the talaromyces marneffei penicillium marneffei. Mcginnis, in pathobiology of human disease, 2014 penicillium marneffei.
C, the fungus shows mycelia growth with septate hyphae, containing conidiophores and conidia similar to that of other penicillium. Penicillium marneffei is a strictly thermally dimorphic fungus 6, recently renamed talaromyces marneffei 7. Habitat penicillium are cosmopolitan, predominant in regions of temperate climate. Penicilliosis, a disseminated and progressive infection caused by penicillium marneffei, is endemic in southeast asia, including thailand, southern china, hong kong, vietnam, indonesia, and laos. Unusual cause of fever and diarrhea in a patient with aids. On occasion, it can also cause disease in such patients who have had travelrelated exposure to this organism.
Disseminated penicillium marneffei infection in an sle. It causes disseminated infection in immunocompromised patients especially in southeast asian countries. Pdf penicillium marneffei infection in aids researchgate. Penicillium marneffei is an emerging opportunistic pathogen. The organism was first reported in 1956 and the first human infection was described in 1973 in an american who lived in southeast asia and was. A case of penicillium marneffei osteomyelitis involving. Penicillium marneffei is a dimorphic fungus endemic in southeast asia. Retrospective analysis of 14 cases of disseminated. Penicillium marneffei is an emerging fungus endemic in southeast asian regions, including burma, cambodia, indonesia, malaysia, thailand, vietnam, and southern parts of china 1,2. Summary penicillium marneffei infection is an important emerging public health problem, especially among patients infected with human immunodeficiency virus in the areas of endemicity in southeast asia, india, and china.
Clinical presentations and outcomes of penicillium marneffei. Department of biological sciences and center for applied chemical biology youngstown state university, youngstown, ohio abstract. Penicillium marneffei, a dimorphic fungus, is a rare opportunistic pathogen. Without timely antifungal treatment, the disease can be fatal. Results fortyseven patients with p marneffei infections were identified from 1 january 1994 to 28 february 2004 inclusive. Penicillium marneffei infection in patients infected with human immunodeficiency virus.
With the prevalence of aids in this area, the number of patients with systemic penicill. Penicillium marneffei infection and recent advances in the epidemiology and molecular biology aspects. Penicillium marneffei is a common fungal infection presenting in hiv coinfected persons in southeast asia, particularly thailand and the southern part of china. Review of eighteen published cases and report of four more chinese cases. Pdf cytological diagnosis of penicillium marneffei infection. Diagnosis of penicillium marneffei infection by quantitation. Talaromyces marneffei, formerly called penicillium marneffei, discovered in 1956, is now regarded as one of the worlds ten most feared fungi. A disease caused by the fungus talaromyces marneffei, which only affects people who live in or visit southeast asia, southern china, or eastern india. Disseminated penicillium marneffei infection in hiv. Talaromyces marneffei, formerly called penicillium. The organism was first reported in 1956 and the first human infection was described in 1973 in an american who lived in southeast asia and was diagnosed with hodgkin lymphoma.
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