First observation in a non-endemic country (Togo) of Penicillium marneffei infection in a human immunodeficiency virus-infected patient: a case report

BMC Research Notes

Palokinam Pitché⁴  Dominique Salmon²  Osseni Tidjani¹  Komi Adjoh¹  Majesté Ihou Wateba¹  Wemboo Afiwa Halatoko³  Koudjo Mawu⁵  Awerou Kotosso¹  Dadja Essoya Landoh⁶  Bayaki Saka⁴  Akouda Akessiwe Patassi¹ 

[1] Service des Maladies Infectieuses et de Pneumologie, CHU Sylvanus Olympio, Lomé, Togo;Service des Maladies Infectieuses et Tropicales, Hôpital Cochin, AP-HP, Paris, France;Institut National d’Hygiène, Ministère de la Santé, Lomé, Togo;Service de Dermatologie, CHU Sylvanus Olympio, Lomé, Togo;Laboratoire de Mycologie et Parasitologie, CHU Sylvanus Olympio, Lomé, Togo;Division de l’Epidémiologie, Ministère de la Santé, BP: 1396 Lomé, Togo

关键词: Togo;    Human Immunodeficiency Virus (HIV);    Penicillium marneffei;   

Others  :  1140596
DOI  :  10.1186/1756-0500-6-506

 received in 2013-07-14, accepted in 2013-12-03,  发布年份 2013

【 摘 要 】

Background

Infection with Penicillium marneffei is a common opportunistic infection in Southeast Asia where it is endemic. We report a case of Penicillium marneffei infection with fatal outcome in a Togolese woman infected with Human Immunodeficiency Virus (HIV).

Case presentation

A 45-years-old patient, infected with Human Immunodeficiency Virus had consulted for ongoing febrile pneumonia since two weeks. Clinical examination revealed fever of 38.5°C, dyspnea, pulmonary syndrome condensation and papulo-nodular of “molluscum contagiosum” like lesions located on the face, arms, neck and trunk. Sputum smear was negative for tuberculosis. The chest radiograph showed reticulonodular opacities in the right upper and middle lobes and two caves in the right hilar region. The CD4 count was 6 cells/mm³ after a year of antiretroviral treatment (Zidovudine-Lamivudine-Efavirenz). She was treated as smear negative pulmonary tuberculosis after a lack of gentamicin and amoxicillin plus clavulanic acid response. Culture of skin samples and sputum had revealed the presence of P. marneffei. A treatment with ketoconazole 600 mg per day was initiated. After two weeks of treatment, there was a decrease in the size and number of papules and nodules, without any new lesions. We noted disappearance of cough and fever. The chest X-ray showed a decrease of pulmonary lesions. There was no reactivation of P. marneffei infection but the patient died from AIDS after two years of follow up.

Conclusion

We report a case of P. marneffei infection in a HIV-infected patient in a non-endemic country. Clinicians should think of P. marneffei infection in all HIV-infected patients with “molluscum contagiosum” like lesions.

【 授权许可】

   
2013 Patassi et al.; licensee BioMed Central Ltd.

【 图 表 】

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